Community Assessment Survey

SMCS Community Needs Assessment Survey

Springfield Medical Care Systems (SMCS) respectfully requests your input in assessing the health care and human services needs of our communities. Please fill out this brief survey and the results will be considered in our planning and shared in our Community Report. All fields are required.

What town do you live in?
What is the top health care concern in your community?
What possible solutions can you identify to the health care concern you listed above?
What do you consider the top problem facing your community?
What possible solutions can you identify to the problem you listed above?
Please select the category that best suits you.
Please tell us your gender.
Do you have health insurance?
Where do you get your hospital care?
Please offer any additional comments.
	Enter the code shown above in the box below