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* 1. How would you describe yourself?

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* 2. How old are you?

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* 3. What is your race/ethnicity?

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* 4. What is your education level?

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* 5. What is your household income?

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* 6. How many people are living in your home?

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* 7. What are the top 3 issues that impact your quality of life?

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* 8. What are the top 3 services that you feel are not available or need improvement in Franklin County?

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* 9. What are the top 3 health behaviors that you need more information on?

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* 10. Where do you get most of your health related information?

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* 11. What is stopping you from getting the care you need?

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* 12. What services do you use at the health department?

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* 13. Is there anything else you would like us to know about your community?

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* 14. What other services do you wish the health department offered?

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