Screen Reader Mode Icon

Question Title

* 1. What do you feel are the 3 most important factors for a healthy community? Please rank the most important factor as 1.

Question Title

* 2. What are the 3 most important health issues facing Waushara County residents?  Please rate the most important factor as 1.

Question Title

* 3. What are the top 3 risky behaviors in Waushara County?  Please rate the riskiest behavior as 1.

Question Title

* 4. Do you have health insurance?

Question Title

* 5. Do you utilize healthcare services in Waushara County?  These services can be offered by Waushara County (for example, mental health services provided by the Waushara County Department of Human Services) or services located within Waushara County (for example, ThedaCare-Wild Rose location).

Question Title

* 6. What is your age?

Question Title

* 7. What is your gender?

Question Title

* 8. What is the highest level of education you completed?

Question Title

* 9. What is your martial status?

Question Title

* 10. What is your race?

Question Title

* 11. What is your annual income level?

Question Title

* 12. What suggestions do you have to help improve the health of Waushara County residents?

Question Title

* 13. If you answered "other" to question 1, 2 and/or 3, please provide your answer here.

0 of 13 answered
 

T