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* 1. How would you rate your overall quality of life as a Mountain Home resident?

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* 2. What is your age range? 

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* 3. What type of leisure activities do you enjoy?
Mark all that apply

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* 4. How do you stay updated on social events and opportunities?

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* 5. How would you rate your overall health?

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* 6. How would you rate your physical health?

1 very unhealthy 5 average 10 very healthy
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 7. How would you rate your mental health?

1 very unhealthy 5 average 10 very healthy
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 8. Does the City of Mountain Home Library, Golf Course or Parks and Recreation Departments positively impact your overall health?

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* 9. Do you agree with the statement below:
The Mountain Home Public Library and the Parks and Recreation department create lifelong learning opportunities for you and your peers.

1 strongly disagree 5 10 strongly agree
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 10. How satisfied are you with current program activities/opportunities offered in Mountain Home?

1 unsatisfied 5 10 very satisfied
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 11. What city park do you visit the most often and why? 
i.e. shade, more space, larger playground etc.

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* 12. On average, how often do you visit the City of Mountain Home public library?

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* 13. On average, how often do you visit the City of Mountain Home golf course?

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* 14. On average, how often do you enjoy Parks and Recreation activities?

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* 15. What recreational opportunities would you like to see in Mountain Home?

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* 16. What other leisure activities would you like to see in Mountain Home?

T