Community Health Needs Form

We appreciate your interest in this community health survey. Your feedback is important. The purpose of this survey is to allow community partners in Northwest Arkansas to better understand and work to address the health-related needs within our NWA community. The survey should take about 15-20 minutes to complete. Your responses are confidential and you may exit the survey at any time.

5. Within the past 12 months, how difficult has it been for you to get the following if/when needed?
Very difficult
Difficult
Somewhat difficult
Not difficult
NA
9. Have you EVER been told by a health care provider that you have or have you EVER been treated for:
Yes
No
Do Not Know
10. Within the past 12 months, have you:
Yes
No
Do Not Know
11. Within the past 12 months, how many times have you:
0
1-2
3-5
6+
Do Not Know