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* 1. What are the top three (3) most important factors when you think of a "healthy community?"

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* 2. What top three (3) factors do you feel are positively affecting the health of Beltrami County?

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* 3. What top three (3) factors do you feel are negatively affecting the health of Beltrami County?

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* 4. How would you rate the overall health of Beltrami County?

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* 5. If Beltrami County were to have a community emergency, what top three (3) emergencies would you feel most prepared for?

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* 6. Do you have any specific ideas to help improve the overall health and wellbeing of Beltrami County?

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* 7. What is your age?

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* 8. What is your gender?

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* 9. What is your total household income?

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* 10. Which race/ethnicity best describes you? (Please choose only one.)

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