Community leaders need your input on the most pressing health and health care issues facing our community in 2015 and beyond. Your responses will inform local community health improvement planning and assist in efforts in building a healthier community. Your individual responses to this survey will remain confidential. This survey should take approximately 10-15 minutes to complete.

In addition, at the end of this survey, you will be asked if you would like your completed survey to be entered into the random drawing for one of the ten (10) $50 VISA gift cards that will be given away. If you are interested, you will be asked to provide a telephone number and/or e-mail address so that we may contact you for mailing information in the event that your completed survey is selected as a winner of a gift card. Again, your telephone number and/or e-mail will remain completely confidential.

Please note that if you are completing this survey online and not on paper, you can go back and change your responses as many times as you would like prior to exiting the survey if you would like to reconsider your responses. Once you exit, however, you will not be able to change or retrieve your responses.

Thanks so very much for your willingness to help the community by completing this survey! If you have any questions about this survey or the survey process, you may contact Jeff Feller at WellFlorida Council (www.wellflorida.org). The phone number is 352-313-6500 and his e-mail address is jfeller@wellflorida.org.

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