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Community Health Visioning Survey

Identifying our community's strengths
Prioritizing the issues that are important to us
Using local resources to make a difference

The Visioning process has significantly strengthened the community. Among the community changes created as a result of the Visioning process has been improved transportation services, improved nutrition in the area schools, expanded mental health services, broader access to education, and an increase in public awareness of community resources and services. Help us continue to make Greater Franklin County a healthy place to live and work!

In the next five years, what should be done to improve the health and quality of life in Greater Franklin County?
What would make you a healthier person or improve your quality of life?

We know there are many issues that need to be addressed in Greater Franklin County.
Please rank the following issues by their importance to you (1 being not critical to 10 being most critical).

	1	2	3	4	5	6	7	8	9	10
Support for older adults Such as caregiving, companioship, help with daily living, staying active and connected
Decreasing substance abuse by improving prevention and treatment resources
Decreasing rates of domestic and sexual violence
Expanding mental health services
Improving access to healthcare Such as help paying for medications or doctors visits, or accessing dental services or other specialty care
Improving transportation options
Increasing physical activity Such as finding affordable recreational opportunities or simply being active
Improving nutrition Such as accessing healthy and affordable local food or simply making healthier choices
Helping people stop using tobacco Such as improving access to products that help with quitting
Support for individuals with chronic conditions Such as diabetes and asthma
Helping people access health information and resources Such as finding information on support groups, housing, health education programs, etc.

Other

Here are suggestions to address the issues that are the most critical to me:

What is working in Greater Franklin County? (What makes this a great place to live in?)
Gender:
Female Male
Age:
What town do you live in?
Do you expect to ever move out of Greater Franklin County?
No Yes
What type of health care coverage/insurance do you have?
Private health insurance (including VA)
MaineCare
Medicare
Franklin Health Access
None
If none, do you wish to be contacted about health insurance?
Yes No
In general, what would you say your health is?
Excellent Very Good Good Fair Poor

Yes! I would like to get involved in improving the health of the community. Please contact me.

Name:

Address:

City:

Zip:

Phone:

Email:

I am very interested in: