* 1. Are you familiar with the services the Health Department provides?

* 2. Have you ever received any services from the Health Department?

* 3. Do the following Health Department services meet the needs of our community?

  Yes No No Opinion
Adult Health (Physical/Wellness)
Animal Shelter/Control
BCCCP/Wisewoman
Care Coordination for Children
Car Seats
Communicable Disease
Employee Health
Environmental Health Plan Review
Family Planning (Birth Control)
Food/Lodging Inspection
Health Promotion and Education
Immunizations
School Health Assessments
Laboratory Services
Maternity Clinic
Nutrition Services
Obstetric Care Management
Septic System Permits
Sexually Transmitted Diseases Clinic
Sports Physicals
Well/Water Permits
Well/Water Sampling
WIC (Women, Infants, and Children)

* 4. Are there any additional services that the Health Department could offer to better meet the needs of our community?

* 5. The Health Department is open Monday-Friday from 8 AM-5 PM. Are these hours of operation sufficient to meet the needs of our community?

* 6. If no, please check the hours that would meet your needs. Check all that apply.

* 7. Additional comments.

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