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Osceola Regional Health Center and Osceola County Public Health are conducting a Community Health Needs Assessment (CHNA) in order to better understand the health concerns of our community. We would appreciate you completing this anonymous, 5- to 15-minute survey so we can learn from your experiences and opinions. As you complete the questionnaire please respond to each question as it relates to Osceola County. Thank you for sharing your ideas and opinions.

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* 1. What is your primary county of residence?

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* 2. My sex is:

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* 3. My age is:

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* 4. The annual income of my household is:

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* 5. What type of health insurance coverage do you have? (Select all that apply)

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* 6. My race/ethnicity is: (Select all that apply)

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* 7. My employment status is:

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* 8. The number of people that are in my household is: (Include people of all ages)

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* 9. The highest level of education I've received is:

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* 10. How satisfied are you with health care (primary care, dental, eye, specialty) within 20 minutes or 30 miles?

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* 11. What specialty services would you or have you received? (Select all that apply)

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* 12. If you are not receiving health care services in Osceola County why did you or your family member seek services elsewhere? (Select all that apply)

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* 13. Have you or someone in your household delayed health care due to any of the following: (Select all that apply)

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* 14. What impact did COVID-19 have on you and your family? (Select all that apply)

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* 15. How satisfied are you with chronic disease prevention, screening, and treatment (examples of chronic diseases include obesity, diabetes, heart disease, and cancer)?

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* 16. How satisfied are you with long term care services (ie nursing home, assisted living)?

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* 17. How satisfied are you with access to mental/behavioral health care within 20 minutes or 30 miles?

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* 18. How satisfied are you with self-harm and suicide prevention programs?

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* 19. Do you identify a need in Osceola County for alcohol and drug abuse prevention and treatment program?

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* 20. Do you identify a need in Osceola County for smoking/vaping prevention and cessation programs?

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* 21. Do you identify a need in Osceola County for shelter and services for victims of abuse?

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* 22. How satisfied are you with emergency services (ie law enforcement, fire, medical)?

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* 23. How satisfied are you with accommodations and services for persons with disabilities?

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* 24. How satisfied are you with access to public transportation (coverage, affordability, ease of use)?

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* 25. How satisfied are you with affordable housing?

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* 26. How satisfied are you with food and nutrition assistance programs (SNAP, WIC, CACFP, Summer Feeding, food pantries, backpack programs, community table)?

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* 27. How satisfied are you with family planning, prenatal, delivery, breastfeeding, and postpartum care (and support)?

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* 28. How satisfied are you with comprehensive and reliable education, regarding sexually transmitted infections (STI) and pregnancy prevention, sexuality education, and HIV screening and prevention?

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* 29. What community services are you aware with in Osceola County?

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* 30. How did you learn about Osceola County community services? (Select all that apply)

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* 31. What are the top community health concerns you want addressed in Osceola County?

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* 32. What services would you like to see offered in Osceola County?

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