Thank you for participating in the 2021 Community Health Needs Assessment of Lebanon County. We are asking for your help to better understand the priorities of our community. Completion of the survey is anonymous and should take less than 10 minutes.
Where do you go to find out about community resources in Lebanon County?
Which newspaper do you read to find out about community resources in Lebanon County?
Which internet site do you visit to find out about community resources in Lebanon County?
Which radio channel do you listen to find out about community resources in Lebanon County?
Rent
Own a home
Live with others in their home
Rent
Own a home
Live with others in their home
What type of dwelling do you rent?
Apartment
Home
Public housing
Assisted housing, such as senior care
Apartment
Home
Public housing
Assisted housing, such as senior care
Tell us the other reason why you rent
Do you have a mortgage for your home?
Yes
No
While living with others do you help pay their rent or mortgage?
Yes
No
The option "
Does your home need...? (Check all that apply)
The option "
When thinking about where you live, do you need...
What is your main form of transportation?
The option "
Do you have any transportation needs? (Check all that apply)
Do you use public transit?
Yes
No
Why not? (Check all that apply)
Can you access the internet from your home?
Yes
No
Tell us why you don't have access to the internet?
What type of device(s) do you have in your home? (Check all that apply)
Do your devices support the needs of the people in your home?
Yes
No
We have to share devices
Our internet cannot support multiple devices
Other
We have to share devices
Our internet cannot support multiple devices
Other
Are you...? (Check all that apply)
Please list any additional training you would be interested in
The option "
When thinking about your work, do you have any of the following needs...? (Check all that apply)
Thinking about your household in the last 12 months, did you have...?
Enough food to eat
Sometimes not enough to eat
Often not enough to eat
Enough food to eat
Sometimes not enough to eat
Often not enough to eat
If you found yourself without enough food, would you know where to go?
Yes
No
Please list any additional skills you are interested in learning
When was the last time you saw your primary care doctor?
Within the past 6 months
Within the past year
Within the past two years
I don't see a doctor due to cost
I don't need to see a doctor
Within the past 6 months
Within the past year
Within the past two years
I don't see a doctor due to cost
I don't need to see a doctor
When you are sick, where do you go most often?
When was the last time you saw your dentist?
Within the past 6 months
Within the past year
Within the past two years
I don't see a dentist due to cost
I don't need to see a dentist
Within the past 6 months
Within the past year
Within the past two years
I don't see a dentist due to cost
I don't need to see a dentist
If you have children, do they have medical insurance?
Yes
No
Not applicable
The option "
Does anything prevent you from getting medical/dental care? (check all that apply)
Do you struggle with your mental wellbeing?
Yes
No
The option "
If yes, have you experienced any of the following on an ongoing basis? (check all that apply)
Have you ever experienced a one-time event (ex: death of a family member, car accident, natural disaster, violent crime etc.) that left you feeling intense helplessness, fear, horror, or shame?
Yes
No
Have you ever experienced a prolonged situation (ex. abuse, neglect, etc.) that left you feeling intense helplessness, fear, horror, or shame?
Yes
No
Have you ever received help with your mental wellbeing?
Yes
No
Yes
No
Who did you contact? (Check all that apply)
The option "
Does anything prevent you from seeking help for your mental wellbeing? (check all that apply)
The option "
Do you or someone you live with currently receive any of the following? (check all that apply)
Public assistance (TANF, cash assistance, medical assistance)
Food assistance (SNAP, WIC, emergency food)
Rental, housing, utilities assistance
Adult services (mental health, intellectual disability, drug and alcohol, housing support)
Children's services (mental health, intellectual disability, early intervention, children and youth)
Other
None of the above
Public assistance (TANF, cash assistance, medical assistance)
Food assistance (SNAP, WIC, emergency food)
Rental, housing, utilities assistance
Adult services (mental health, intellectual disability, drug and alcohol, housing support)
Children's services (mental health, intellectual disability, early intervention, children and youth)
Other
None of the above
When thinking about community services, does any of the following apply to you? (check all that apply)
How do you describe yourself?
Male
Female
Transgender
Do not identify as female, male, or transgender
Prefer not to answer
Male
Female
Transgender
Do not identify as female, male, or transgender
Prefer not to answer
Do you consider yourself to be?
Bisexual
Gay or lesbian
Straight, that is not gay or lesbian
Other
Don't know
Prefer not to answer
Bisexual
Gay or lesbian
Straight, that is not gay or lesbian
Other
Don't know
Prefer not to answer
The option "
What best describes you? (Check all that apply)
What best describes your ethnicity?
Hispanic/Latino
Non-Hispanic/Latino
None of the above
Hispanic/Latino
Non-Hispanic/Latino
None of the above
What is your preferred language?
English
Spanish
Other
18-24
25-34
35-44
45-54
55-64
65+
18-24
25-34
35-44
45-54
55-64
65+
Including yourself, check a box if someone in your household is in these age categories. (Check a box for all the people in your household, you will be asked how many next)
How many? (0-6 years old)
How many? (7-18 years old)
How many? (19-64 years old)
How many? (65+ years old)
What do you think is your annual household income from all sources?
Less than $15,000
$15,001 to $25,000
$25,001 to $50,000
$50,001 to $75,000
$75,001 to $100,000
More than $100,001
Less than $15,000
$15,001 to $25,000
$25,001 to $50,000
$50,001 to $75,000
$75,001 to $100,000
More than $100,001
Were you born in Lebanon County?
Yes
No
Why did you come to live here?
What is your municipality?
Annville Township
Bethel Township
City of Lebanon
Cleona Borough
Cornwall Borough
East Hanover Township
Heidelberg Township
Jackson Township
Jonestown Borough
Millcreek Township
Mt. Gretna Borough
Myerstown Borough
North Annville Township
North Cornwall Township
North Lebanon Township
North Londonderry Township
Palmyra Borough
Richland Borough
South Annville Township
South Lebanon Township
South Londonderry Township
Swatara Township
Union Township
West Cornwall Township
West Lebanon Township
Don't know
Annville Township
Bethel Township
City of Lebanon
Cleona Borough
Cornwall Borough
East Hanover Township
Heidelberg Township
Jackson Township
Jonestown Borough
Millcreek Township
Mt. Gretna Borough
Myerstown Borough
North Annville Township
North Cornwall Township
North Lebanon Township
North Londonderry Township
Palmyra Borough
Richland Borough
South Annville Township
South Lebanon Township
South Londonderry Township
Swatara Township
Union Township
West Cornwall Township
West Lebanon Township
Don't know
Thank you for completing this survey! If any of our questions make you feel uncomfortable, or you're having a mental health crisis, there are local services available: Lebanon County Crisis Intervention: (717) 274-3363 or Crisis Text Line: Text “PA” to 741741
Working...