Demographics

Zip code where you live

Question Title

* 1. Zip code where you live

Zip code where you work

Question Title

* 2. Zip code where you work

Age

Question Title

* 3. Age

Gender

Question Title

* 4. Gender

Ethnic Group

Question Title

* 5. Ethnic Group

Language spoken at home

Question Title

* 6. Language spoken at home

Is understanding the English language a problem for you?

Question Title

* 7. Is understanding the English language a problem for you?

Are you satisfied with the health care system in Taylor County?

Question Title

* 8. Are you satisfied with the health care system in Taylor County?

What do you think are the THREE most important factors for a "Healthy Community?" (Those factors which most improve the quality of life in a community) Check only three:

Question Title

* 9. What do you think are the THREE most important factors for a "Healthy Community?" (Those factors which most improve the quality of life in a community) Check only three:

What do you think are the THREE most important "health problems" in Taylor County?

Question Title

* 10. What do you think are the THREE most important "health problems" in Taylor County?

Select the top THREE health challenges YOU face:

Question Title

* 11. Select the top THREE health challenges YOU face:

Do you have school age children?

Question Title

* 12. Do you have school age children?

If yes, which grades?

Question Title

* 13. If yes, which grades?

Are you raising children that are your grandchildren?

Question Title

* 14. Are you raising children that are your grandchildren?

What issues do your school age children face?

Question Title

* 15. What issues do your school age children face?

How would you rate Taylor County as a "Healthy Community?"

Question Title

* 16. How would you rate Taylor County as a "Healthy Community?"

How would you rate your personal health?

Question Title

* 17. How would you rate your personal health?

Where do you go for routine healthcare?

Question Title

* 18. Where do you go for routine healthcare?

If you answered "I don't receive routine healthcare" to number 18, please choose all reason why below.

Question Title

* 19. If you answered "I don't receive routine healthcare" to number 18, please choose all reason why below.

How often have you used the Emergency Room in the past 12 months?

Question Title

* 20. How often have you used the Emergency Room in the past 12 months?

How often have you used the Emergency Room in the past 12 months for a child in your care?

Question Title

* 21. How often have you used the Emergency Room in the past 12 months for a child in your care?

What means of transportation do you use?

Question Title

* 22. What means of transportation do you use?

What preventative health services do you use?

Question Title

* 23. What preventative health services do you use?

The last time you used a health care facility in Taylor County did you feel you received enough information/education to recover?

Question Title

* 24. The last time you used a health care facility in Taylor County did you feel you received enough information/education to recover?

  Yes No
Taylor Regional Hospital
Doctors Office
In your opinion, what is the best way to address the health needs of people in Taylor County? (Please choose one)

Question Title

* 25. In your opinion, what is the best way to address the health needs of people in Taylor County? (Please choose one)

What group needs the most help with access to health care in Taylor County?

Question Title

* 26. What group needs the most help with access to health care in Taylor County?

Name one way to improve the health of Children?

Question Title

* 27. Name one way to improve the health of Children?

If the following screenings were available which ones would you be interested in doing? (Choose all that apply)

Question Title

* 28. If the following screenings were available which ones would you be interested in doing? (Choose all that apply)

How do you find out about community events, classes, or programs in Taylor County?

Question Title

* 29. How do you find out about community events, classes, or programs in Taylor County?

Suggestion for classes:

Question Title

* 30. Suggestion for classes:

T