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* 1. Affordable Housing is a problem in this community because: (check all that apply)

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* 2. Companies are short staffed in this community because: (check all that apply)

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* 3. High heating and utility costs are a problem in this community because: (check all that apply)

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* 4. Transportation is a problem because: (check all that apply)

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* 5. Please choose 3 of the following areas that are most important to you right now.

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* 6. In your view of the following, which are most important to having a good community? (choose 3)

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* 7. Which of the following are missing from your neighborhood? (check all that apply)

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* 8. For those that are pregnant or have a family member or friend who may be expecting a baby: With the closing of Labor/Delivery at Promedica Hospital in Coldwater, please circle how much of a hardship it is/was to go out of county for services: (1 being not really and 10 being very)

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* 9. What county are you/they now going to for prenatal care/delivery?

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* 10. What is your usual work or school schedule?

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* 11. Do you use childcare outside of your home while you work or attend school?

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* 12. If you use childcare, do you utilize family members or a licensed childcare center?

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* 13. If you do not use licensed childcare, please tell us why. Mark all that apply:

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* 14. Do you feel there is an issue with substance abuse in the county?

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* 15. Do you feel you have access to mental health support? If yes, where do you go for that support? If no, what is preventing you from seeking help?

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* 16. Source of Income (Note: If you have more than one source of income, check all that apply):

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* 17. Which do you have at home (check all that apply):

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* 18. Do you have access to the internet at home?

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* 19. Do you own a home or rent?

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* 20. What two social media formats do you use the most?

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