Project 17 Regional Assessment - Stakeholders Question Title * 1. The county where I live Allen Anderson Bourbon Chautauqua Cherokee Coffey Crawford Elk Franklin Greenwood Labette Linn Miami Montgomery Neosho Wilson Woodson None of the above Question Title * 2. The county where I work Allen Anderson Bourbon Chautauqua Cherokee Coffey Crawford Elk Franklin Greenwood Labette Linn Miami Montgomery Neosho Wilson Woodson Multiple counties Question Title * 3. I am affiliated with one of the following groups city government county government institution of higher education unified school district law enforcement chamber of commerce business owner but not affiliated with the chamber of commerce mental health department non-profit agency; e.g. YMCA, Boys and Girls Club public housing authority health department veteran services social service agency; e.g. Catholic Charities, Salvation Army correctional facility community action agency student other Other (please specify) Question Title * 4. Are you required by a governing authority to conduct your own communiity assessment? yes yes and I would like to partner with this initiative for a comprehensive assessment no no, but there are data elements that I am interested in exploring Email Address Question Title * 5. Community assessment data elements I am interested in exploring, regardless of answering yes or no in the question above housing health demographics economic development educational achievement child care availability child mortality other Other (please specify) Question Title * 6. Names and contact information of major opinion leaders in your community Question Title * 7. Names and contact information of entities that should be included in this regional assessment Question Title * 8. Community Planning Issuess: Rank the following community issues in order of thier importance to your community. The drop down menu will automatically move your selections as you make them. 1 2 3 4 5 6 7 8 slow economy and cannot keep pace with cost of living 1 2 3 4 5 6 7 8 crime; e.g. I feel unsafe 1 2 3 4 5 6 7 8 access to legal services 1 2 3 4 5 6 7 8 built environment; e.g. recreation/community recreation accessibility 1 2 3 4 5 6 7 8 educational achievement; e.g. is the community working with the school district to educate our children? 1 2 3 4 5 6 7 8 infrastructure upgrades; e.g. streets, sewers, water supply 1 2 3 4 5 6 7 8 leadership; e.g. working together to make things better (city, county, school district, chamber of commerce, college, hospital, etc.) 1 2 3 4 5 6 7 8 job growth; e.g. access to high speed internet, skills training for those who need it Question Title * 9. Employment: Rank barriers to employment as they relate to your community. The drop down menu will automativally move your selections as you select them. 1 2 3 4 5 6 access to education 1 2 3 4 5 6 cost of education 1 2 3 4 5 6 access to living wage jobs 1 2 3 4 5 6 lack of employment opportunities 1 2 3 4 5 6 lack of public transportation to and from work 1 2 3 4 5 6 lack of affordable child care Question Title * 10. Health Issues: Rank these health issues in order of their importance to your community. The drop down menu will automatically move your selections when you make them. 1 2 3 4 5 6 7 8 9 10 11 cost of primary health care 1 2 3 4 5 6 7 8 9 10 11 access to primary health care 1 2 3 4 5 6 7 8 9 10 11 cost of mental health care 1 2 3 4 5 6 7 8 9 10 11 access to mental health care 1 2 3 4 5 6 7 8 9 10 11 cost of nutritious food 1 2 3 4 5 6 7 8 9 10 11 access to nutritious food 1 2 3 4 5 6 7 8 9 10 11 affordable housing 1 2 3 4 5 6 7 8 9 10 11 obesity 1 2 3 4 5 6 7 8 9 10 11 substance abuse; e.g. drugs, alcohol 1 2 3 4 5 6 7 8 9 10 11 tobacco and smokeless tobacco use 1 2 3 4 5 6 7 8 9 10 11 access to physical activity Question Title * 11. Are you willing to do any of the following? participate in an individual or small group interview participate in a facilitated community conversation host a community conversation Email Address Done