We want to hear your thoughts about important health issues in your community.

Together, the Ulster County Department of Health and hospitals throughout Ulster County, NY, will use the results of this short survey and other information to help improve health programs in your community. Your responses are completely anonymous. Please submit your responses by September 15, 2016. Thank you for your participation!

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* 1. What are the THREE biggest ongoing health concerns for the COMMUNITY WHERE YOU LIVE?

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* 2. What are the THREE biggest ongoing health concerns for YOURSELF?

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* 3. What THREE things would be most helpful to improve YOUR health concerns?

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* 4. How would you rate your overall PHYSICAL HEALTH on most days?

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* 5. How would you rate your overall EMOTIONAL and MENTAL HEALTH on most days?

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* 6. Do you suffer from any chronic health conditions (please check all that apply)?

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* 7. Do you have a health care provider for checkups and visits?

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* 8. How long has it been since you visited a health care provider for a routine physical exam or checkup?

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* 9. What THREE things prevent YOU from getting medical care from a health provider?

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* 10. In the past 12 months, did you receive care in the emergency room?

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