Countryside Public Health Community Survey

Every 4-5 years CPHS tries to touch base with the public to determine what they feel are the public health concerns in their communities. Please take a few minutes to answer some questions about the health of people in your county.

1. About how long has it been since you last visited a doctor for a routine checkup? A routine checkup is a general physical exam, not an exam for a specific injury, illness, or condition.

Within past year
Within past 2 years
Within past 5 years
Five or more years ago

2. Do you have health insurance or Medicare?

Yes
No

3. Do you have a deductible for your health insurance?

Yes
No

If Yes - How much?

Less than $1000
$1000-2000
over $2000

4. If you have a deductable for your health insurance, do you fail to seek services because of concerns of out of pocket expenses?

Yes
No
I do not have a deductable

5. If you could decide where Countryside Public Health should concentrate our efforts, what would be your top 5 priorities from the list below?

Please place an “X” in your top 5 issues:

Provide information to pregnant women and new parents to help their children develop in healthy ways.

Partner with communities to reduce obesity in children and adults.

Partner with communities to reduce smoking.

Assist families with installing car seats correctly.

Provide water testing and consultation for private wells and municipalities.

Provide education to families with children that have elevated levels of lead in their blood.

Work with high school administration and faculty to provide evidence-based education to prevent unplanned pregnancies and sexually transmitted diseases.

Join with community partners to assure that adequate services are available to families in the community. (home care, etc)

Help to identify and reduce infectious disease outbreaks like TB and whooping cough.

Work with community partners to reduce traffic crashes.

Plan for public health emergencies.

Provide WIC (federal food vouchers and nutrition education) to pregnant mothers and families with young children.

6. These last questions are to help us compare your answers with those of others who participate in this survey.

Under 18
18-24 yrs
25-39 yrs
40-54 yrs
55-64 yrs
65+

7. Sex:

Male
Female

8. County:

Big Stone
Chippewa
Lac qui Parle
Swift
Yellow Medicine

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News and Events

May 13, 2013
DRINK THAT WATER

February 14, 2013
SAD/Seasonal Affective Disorder

April 4, 2013
Mother's Against Drunk Driving

April 4, 2013
National Public Health

Have a Question?

Just pick up the phone and give us a call!

Ortonville - 1-866-277-5587
Montevideo - 1-800-894-0192
Madison - 1-800-255-0736
Benson - 1-800-657-3291
Granite Falls - 1-800-407-3628
WIC - 1-800-244-6026

Monday-Friday
8:30 am to 4 pm