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Health Equity Action Transformation (HEAT) Survey
1.
Which of the following words would you use to describe your organization? Select all that apply.
Business - Private
Commercial / Retail
Communications / IT
Education
Faith-Based
Government
Health / Healthcare / Clinical
Legal / Justice System
Marketing / PR
Non Profit
Student
Other (please specify)
2.
How did you hear about the HEAT Report and/or Redlined Comics?
Advertisement
Article
Colleague
Email / Newsletter
Family or Friend
News Story
Presentation / Convention
School / University
Social Media
Web Search
Other (please specify)
3.
How well did the HEAT Report and/or Redlined Comic meet your needs?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
Other (please specify)
4.
How would you rate the quality of the HEAT Report and/or Redlined Comic?
Very high quality
High quality
Neither high nor low quality
Low quality
Very low quality
5.
How relevant is the HEAT Report an/ or Redlined Comic to your work, personal interest, or area of study?
Extremely relevant
Very relevant
Somewhat relevant
Not so relevant
Not at all relevant
Not applicable
Other (please specify)
6.
How would you rate the importance of equity in your work and/or area of study?
Extremely important
Very important
Somewhat important
Not so important
Not at all important
Other (please specify)
7.
On a scale of 0 to 10,
How likely is it that you would recommend the HEAT Report and/or Redlined Comic to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
8.
Please share a brief note of how you have used the HEAT Report and/or Redlined Comic in your work or area of study?
9.
Do you have any other comments, questions, or concerns?
10.
We are eager to understand how HEAT may have impacted your or your work/study. If you would be willing to share your insights, please provide your contact information below. Thank you!
Name
Company
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
Country
Email Address
Phone Number