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Public Social Services Plan Survey - Town of Athol

Town of Athol - Public Social Services Planning Survey

The Town of Athol is conducting a health-related survey of the community's inhabitants. The survey is anonymous. Information gathered will be used to complete a Public Social Services Plan. This plan will be used to guide future decision-making related to addressing human services needs in Athol. All public input is welcome and encouraged. Multiple members from each household are encouraged to take this survey. Please help your municipal leaders with this planning process. The survey questions may be accessed via the link and QR code, provided below. The estimated time to complete this survey is under five minutes.
1.Do you use a primary care (i.e. family) doctor for most of your routine health care?
(If Yes, skip to question #3)
2.If you responded "No" in Question #1, then what kind of medical provider do you use for routine care?
3.The following list includes amenities identified in your community as those that have some impact (positive or negative) on the health and well-being of the overall community. Please rank each based on how YOU BELIEVE they impact the health and well being of the overall community.
Negatively
Somewhat Negatively
Neither Positive or Negative
Somewhat Positively
Positively
Not Applicable
Healthcare Service, Athol Hospital
Healthcare Service, Urgent Care Center, Athol
Healthcare Service, Other Medical Facilities or Offices
Cultural Asset, Library
Cultural Asset, Performing Arts Spaces and/or Organizations
Cultural Asset, Millers River Environmental Center
Cultural Asset, Public Spaces
Recreational Asset, YMCA
Recreational Asset, School-based Athletics Programs
Recreational Asset, Walking/Biking/Boating Trails
Food System Asset, Full-Service Grocery Stores
Food System Asset, Community Gardens
Food System Asset, Farmer's Markets
Food System Asset, Food Cooperative
Public Safety Asset, Police, Fire and EMT services
Public Safety Asset, Environmental Protection Agencies
Employment Asset, Major Employers
Employment Asset, Small Employers
Employment Asset, Unemployment and Job Placement Services
Transportation Asset, Public Transportation Provider - MART or FRTA
Transportation Asset, Uber, Lyft, or other Ridesharing Service
Transportation Asset, Any Other Health Visit Transportation Service (non-MART, non-FRTA, non-ridesharing service)
Housing Asset, Homeless Prevention and Housing Organizations
Housing Asset, Home Improvement and/or Weatherization Program(s)
Educational Asset, Childcare and Preschool Provider(s)
Educational Asset, K-12 School District (Athol-Royalston)
Educational Asset, School District (Outside of Athol Royalston)
Educational Asset, Colleges and Universities
Organizational Asset, Informal Groups and Meetings
Organizational Asset, Multi-Sector Coalitions
Organizational Asset, Local Charities
Organizational Asset, North Quabbin Community Coalition
Organizational/Municipal Asset, Senior Center
Organizational Asset, Salvation Army
Fraternal Organization, Freemasons
Fraternal Organization, Order of Eagles
Fraternal Organization, Veterans of Foreign Wars
Fraternal Organization, American Legion
NELCWIT: New England Learning Center for Women in Transition
4.In past surveys, community members identified common themes or issues such as those listed, below. How have these issues "changed" FOR YOU PERSONALLY over the past few years?
Worsened a Great Deal
Worsened Somewhat
Neither Improved or Worsened
Improved Somewhat
Improved a Great Deal
Not Applicable
Cost of Accessing or Utilizing Health Care
Language and Cultural Barriers
Mental Health, Depression, Suicide and Stress 
Substance Abuse 
Social Isolation
Transportation
Unemployment and Poverty
Chronic Conditions (i.e. Diabetes and Heart Disease, etc.)
Cancer
Environmental Conditions (i.e. Water and air pollution, etc.)
Violence and Public Safety
Oral Health
Coronavirus 2019 ("COVID-19")
Housing Costs
Job Security
5.If you need more information on a health topic, FROM WHOM do you obtain information?
Never
Sometimes
Most of the TIme
All of the time
Primary Care Physician (PCP)
Nurse
Commercial Advertising
Online Medical Resources
Council On Aging or Senior Center
Municipal Health Agent
Teacher
Family
Friends
6.If you need more information on a health topic and obtain it from one or more sources identified in the previous question, HOW do you obtain the information? (Select as many as apply to you)
7.Are you able to obtain an appointment with your primary care physician (family doctor) when you need one? If no, please explain why.
8.Do you receive all of your healthcare services locally?
9.If you answered "No" to the previous question, for what services do you travel outside of your local area? (Select as many as apply to you)
10.If you have to travel out of your town for the service(s) identified in the previous question, why did you choose to leave town for this health service? If "Other", please specify in the comment box below. (Select as many as apply to you)
11.Have you, or someone in your household, delayed healthcare due to a lack of any of the following? (Select as many as apply to you)
12.List any other barrier(s) that delayed you from getting the care you needed?
13.Is there one final comment that you would like to make about the health of the people in your community? For example, what one recommendation can you offer for improved health care services (i.e. programs, resources, policies)?
14.Gender: How do you Identify?
15.Which of the following describes your race/ethnicity? Multiple responses are allowed.
16.What is the primary language spoken in your home?
17.What is your age?
18.What is the zip code of your residence?
19.What is the Zip Code of your work place?