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* 1. Have you ever utilized services and/or programs from the Jessamine County Health Department (JCHD)?

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* 2. Please check all preventative (medical) services that you have used. (check all that apply)

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* 3. Please select the following that pertain to you. (check all that apply)

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* 4. Have your children been involved in any of the health programs/services at school? (check all that apply)

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* 5. Are you aware or have you participated in the HANDS program (Health Access Nurturing Development Services) for first time parents?

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* 6. Have you participated in any of the following worksite/offsite wellness programs in which the Jessamine County Health Department was involved? (check all that apply)

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* 7. Where do you go for health information? (Choose all that apply)

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