City of West Covina - Community Health Assessment

The information collected from this survey will be used to assist us to make informed decision to better our communities in West Covina.  The cumulative results from this survey may be published for education purposes and/or future research studies without further informed consent from you.  Information collected from this form will be kept strictly confidential.  Your participation in completing this form is voluntary and may be withdrawn at any time.  There will be no negative consequences if you choose not to participate.  There are no known risks associated with completing this form.  Completion of this form will be considered as your consent to participate.  Thank you!