Austin Community Health Hub Feedback Survey

Question Title

* 1. What is your relationship to the Austin community? Please select all that apply.

I live here

I work here

I go to school here

My children go to school here

My organization/business serves the Austin community

I don’t have a relationship to the Austin community

Other (please specify)

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* 2. How do you know Lively Stone / Stone CDC? Please select all that apply.

I am a parishioner of Lively Stone Church

I work/volunteer/support Lively Stone or Stone CDC

I have heard of Stone but I don’t have a relationship with them

I do not know anything about Lively Stone / Stone CDC

Other (please specify)

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* 3. How do you know Lurie Children’s Hospital? Please select all that apply.

My child or a child I know is or has been a patient there

I work/volunteer/support Lurie Children’s

I have heard of Lurie Children’s but I don’t have a relationship with them

I do not know anything about Lurie Children’s

Other (please specify)

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* 4. Do you think there is a need for this project and these services on Chicago Avenue in Austin?

Yes, this project and these services are needed in the Austin community

No, we already have these services and/or they are not needed

I’m not sure yet

Other (please specify)

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* 5. Do you think the project should include a café serving the community?

Yes, a café is an important part of this project

It would be nice, but not very important to me

No, we do not need a café here

I’m not sure yet

Other (please specify)

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* 6. We'd like to hear what you think should be included if there is an outdoor space. Please let us know how important each of the options are below and share if you have any additional ideas.

	Not important	A little important	Important	Very important	I'm not sure
Playground for kids	Playground for kids Not important	Playground for kids A little important	Playground for kids Important	Playground for kids Very important	Playground for kids I'm not sure
Quiet space to relax	Quiet space to relax Not important	Quiet space to relax A little important	Quiet space to relax Important	Quiet space to relax Very important	Quiet space to relax I'm not sure
Community garden	Community garden Not important	Community garden A little important	Community garden Important	Community garden Very important	Community garden I'm not sure
Café seating	Café seating Not important	Café seating A little important	Café seating Important	Café seating Very important	Café seating I'm not sure

Do you have any other ideas or additional comments?

Question Title

* 7. In your opinion, which of these potential youth clinical services should be included?

	Not important	A little important	Important	Very important	I'm not sure
Asthma	Asthma Not important	Asthma A little important	Asthma Important	Asthma Very important	Asthma I'm not sure
Autism Care	Autism Care Not important	Autism Care A little important	Autism Care Important	Autism Care Very important	Autism Care I'm not sure
Behavioral Health Crisis Evaluation Services for Local Schools	Behavioral Health Crisis Evaluation Services for Local Schools Not important	Behavioral Health Crisis Evaluation Services for Local Schools A little important	Behavioral Health Crisis Evaluation Services for Local Schools Important	Behavioral Health Crisis Evaluation Services for Local Schools Very important	Behavioral Health Crisis Evaluation Services for Local Schools I'm not sure
Behavioral Health for Youth with Developmental Disabilities	Behavioral Health for Youth with Developmental Disabilities Not important	Behavioral Health for Youth with Developmental Disabilities A little important	Behavioral Health for Youth with Developmental Disabilities Important	Behavioral Health for Youth with Developmental Disabilities Very important	Behavioral Health for Youth with Developmental Disabilities I'm not sure
Blood Disorders (including Hemophilia and Sickle Cell Disease)	Blood Disorders (including Hemophilia and Sickle Cell Disease) Not important	Blood Disorders (including Hemophilia and Sickle Cell Disease) A little important	Blood Disorders (including Hemophilia and Sickle Cell Disease) Important	Blood Disorders (including Hemophilia and Sickle Cell Disease) Very important	Blood Disorders (including Hemophilia and Sickle Cell Disease) I'm not sure
Fatty Liver Clinic	Fatty Liver Clinic Not important	Fatty Liver Clinic A little important	Fatty Liver Clinic Important	Fatty Liver Clinic Very important	Fatty Liver Clinic I'm not sure
General Adolescent Medicine	General Adolescent Medicine Not important	General Adolescent Medicine A little important	General Adolescent Medicine Important	General Adolescent Medicine Very important	General Adolescent Medicine I'm not sure
General Gastrointestinal	General Gastrointestinal Not important	General Gastrointestinal A little important	General Gastrointestinal Important	General Gastrointestinal Very important	General Gastrointestinal I'm not sure
Headache	Headache Not important	Headache A little important	Headache Important	Headache Very important	Headache I'm not sure
Home-based Behavioral Health Services	Home-based Behavioral Health Services Not important	Home-based Behavioral Health Services A little important	Home-based Behavioral Health Services Important	Home-based Behavioral Health Services Very important	Home-based Behavioral Health Services I'm not sure
Infectious Disease	Infectious Disease Not important	Infectious Disease A little important	Infectious Disease Important	Infectious Disease Very important	Infectious Disease I'm not sure
Nephrology (including Kidney Disease)	Nephrology (including Kidney Disease) Not important	Nephrology (including Kidney Disease) A little important	Nephrology (including Kidney Disease) Important	Nephrology (including Kidney Disease) Very important	Nephrology (including Kidney Disease) I'm not sure
Preventative Cardiology	Preventative Cardiology Not important	Preventative Cardiology A little important	Preventative Cardiology Important	Preventative Cardiology Very important	Preventative Cardiology I'm not sure
Reproductive Health (including HIV/STI Testing)	Reproductive Health (including HIV/STI Testing) Not important	Reproductive Health (including HIV/STI Testing) A little important	Reproductive Health (including HIV/STI Testing) Important	Reproductive Health (including HIV/STI Testing) Very important	Reproductive Health (including HIV/STI Testing) I'm not sure
Respite Care	Respite Care Not important	Respite Care A little important	Respite Care Important	Respite Care Very important	Respite Care I'm not sure
Substance Use	Substance Use Not important	Substance Use A little important	Substance Use Important	Substance Use Very important	Substance Use I'm not sure
Wellness and Weight Management	Wellness and Weight Management Not important	Wellness and Weight Management A little important	Wellness and Weight Management Important	Wellness and Weight Management Very important	Wellness and Weight Management I'm not sure

Do you have any other ideas or additional comments?

Austin Community Health Hub Feedback Survey

Question Title

* 1. What is your relationship to the Austin community? Please select all that apply.

Question Title

* 2. How do you know Lively Stone / Stone CDC? Please select all that apply.

Question Title

* 3. How do you know Lurie Children’s Hospital? Please select all that apply.

Question Title

* 4. Do you think there is a need for this project and these services on Chicago Avenue in Austin?

Question Title

* 5. Do you think the project should include a café serving the community?

Question Title

* 6. We'd like to hear what you think should be included if there is an outdoor space. Please let us know how important each of the options are below and share if you have any additional ideas.

Question Title

* 7. In your opinion, which of these potential youth clinical services should be included?

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* 8. What should we keep in mind about the look and feel of this space as we begin designing?

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* 9. Please share any other information, questions, concerns or ideas you have about this project:

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* 10. Please share your email if you want to receive updates about the project and future meetings.