CVMC Community Assessment |
Central Vermont Medical Center (CVMC) survey below is used to assess the health care and human services needs in Washington County. We are very interested in your input. Please fill out the survey as the results will be shared with the public in our Community Report. |
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What do you think is the best thing about our community? |
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What do you consider is the top HEALTH AND WELLNESS concern in our community? |
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What is a possible solution to the top HEALTH AND WELLNESS concern you listed above? |
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What do you consider is the top PROBLEM facing our community? |
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What is a possible solution to the top PROBLEM you listed above? |
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What town do you live in? |  | |
Please select the category that best suits you: |  | Healthcare Professional Community Member Local Business Professional Government Official Other |
Please tell us your gender |  | Male Female |
Please indicate your age: |  | |
Household annual income: |  | |
What is the highest last grade of school you completed? |  | Some High School (No Diploma) High School Diploma / GED Some College (No Degree) Associates Degree Bachelors Degree Graduate Degree Doctorate |
Please indicate the race that best describes you. |  | African American / Black American Indian Alaska Native Asian Native Hawaiian Pacific Islander White Other |
Do you have Health Care Insurance? |  | Yes No
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Where do you get your hospital care? |  | |
Please take the space below to provide additional input/comments. |
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