Henry County Health Center Needs Assessment

By completing this survey, you agree to have your responses complied with other community member responses and presented only in aggregate form. This survey is to evaluate your knowledge of current services provided by Henry County Health Center, as well as a developmental tool for new initiatives at the Health Center. No identifying information will be collected, and your responses will remain confidential by coding your responses with a unique study number. Furthermore, your responses will be kept locked and be viewed only by the research staff at Henry County Health Center. You do not have to complete this survey, and please understand that your participation is completely voluntary. If you have any questions about the survey purpose, questions, or any other issues, please contact ...

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* 1. How long have you been a resident of Henry County ?

Less than a year

1-3 years

4-6 years

7-9 years

10 or more years

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* 2. Do you currently have Health Insurance ?

Yes

I have a form of Health Insurance (please specify)

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* 3. How often do you use services provided by Henry County Health Center?

Always

Sometimes

Rarely (1-3 times a year)

Never

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* 4. In the past year, what Henry County Health Center WIC services have you used ?

Normal WIC Programming Services

Breastfeeding Services

None

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* 5. In that past year, what Henry County Health Center Nursing Services have you used ?

Flu Shots

Immunizations

STD testing

Pregnancy testing

Rural Health Nursing / School Nursing services

None

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* 6. In the past year, what Henry County Health Center Community Programs have you used?

Car Seat Program

Safe Cribs Program

DayCare Provider Education Program

CPR/ First Aid Training

Vital Records Services

Emergency Preparedness Program

Distracted Driving Program

None

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* 7. In the past year what Henry County Health Center Food/Septic services have you used?

Attending Food Handler trainings / receiving a Food Handler Card

Learning Regulations

Obtaining a Food Permit

Learning Septic Information

None

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* 8. Do you have adequate transportation to and from Henry CountyHealth Center?

Yes

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* 9. Do you have adequate access to internet service?

Yes

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* 10. What services provided by Henry County Health Center would you be interested in?

Mental Health Services

Battery Disposal/ Recycle Services

Asbestos Testing/ Removal

Transportation Services to and from the Health Center

Other (please specify)

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* 11. What new Henry County Health Center initiatives have you participated in?

Baby Shower

Safe Driving

Animal Rabies Clinic

Senior Event

Old Glory Days Lactation/ Diaper change tent

Mothers Brunch

Other (please specify)

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* 1. How long have you been a resident of Henry County ?

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* 2. Do you currently have Health Insurance ?

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* 3. How often do you use services provided by Henry County Health Center?

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* 4. In the past year, what Henry County Health Center WIC services have you used ?

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* 5. In that past year, what Henry County Health Center Nursing Services have you used ?

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* 6. In the past year, what Henry County Health Center Community Programs have you used?

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* 7. In the past year what Henry County Health Center Food/Septic services have you used?

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* 8. Do you have adequate transportation to and from Henry CountyHealth Center?

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* 9. Do you have adequate access to internet service?

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* 10. What services provided by Henry County Health Center would you be interested in?

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* 11. What new Henry County Health Center initiatives have you participated in?

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* 12. What changes or suggestions do you have for the Health Center ?