MCH Public Input Survey 2017

Thank you for taking the time to complete the Public Input Survey on Maternal and Child Health.  Information you provide will supplement the Public Input section of the Health Resources and Services Administration (HRSA) Title V Block Grant.  Your information will be confidential. The survey should take approximately 5-6 minutes to complete. 

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* 1. I would like to complete the survey as a:

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* 2. Based on your knowledge and experiences over the past 12 months, what are the most important unmet needs impacting the health of infants, children, adolescents, children and youth with special health care needs, pregnant women, and women of reproductive age in your community?


Please describe your community in your response.

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* 3. Based on your knowledge and experiences over the past 12 months, what are the most important emerging issues impacting the health of infants, children, adolescents, children and youth with special health care needs, pregnant women, and women of reproductive age in your community?


Please describe your community in your response.

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* 4. What specific recommendations/suggestions do you have for strengthening and/or improving the health of children in your community?

 
Please describe your community in your response.

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* 5. What specific recommendations/suggestions do you have for strengthening and/or improving the health of children and youth with special health care needs in your community?


Please describe your community in your response.

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* 6. What specific recommendations/suggestions do you have for strengthening and/or improving the health of women of reproductive age in your community?

 
Please describe your community in your response.

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* 7. What specific recommendations/suggestions do you have for strengthening and/or improving the health of pregnant women in your community?
 

Please describe your community in your response.

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* 8. Do you have any general feedback for the Maternal and Child Health Program?

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