Youth Community Health Survey

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Please answer the following questions about your community to help Healthy Acadia plan and offer future programs and services for youth in Washington and Hancock counties.

In this survey, HEALTH can include: physical, mental, emotional, and spiritual health. Whatever Health means to you!

In this survey, COMMUNITY is whatever it means to you: it can be your town, your school, your neighborhood, your region, groups you are part of, etc!

1. What do you like most about living in your community?

2. What strengths contribute to health for youth in your community?

3. Are there things that get in the way of youth health in your community? What concerns do you have, or concerns that you hear others express?

4. What projects or activities are you already involved in that are helping to address the challenges you see?

5. Are there any specific ideas or projects that you would like to see accomplished in your community, to support and improve health for youth?

6. What gender do you identify as?

7. What is your race and ethnicity?

8. Which of the following best describes you?

I am not sure about my sexual identity (questioning)

Heterosexual (straight)

Asexual (Ace)

Gay or lesbian

I describe my sexual identity some other way

Bisexual

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9. What is your age?

Under 12

19 or older

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10. What town do you live in?

11. What school do you attend?

12. Can you easily walk or ride your bike to school, stores, parks, and other activities?

Yes

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13. Do you participate in any extracurricular activities (sports, clubs, music, drama, art, etc)? If so, how many:

None

2-4

4 or more

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14. How long have you lived in your county?

My whole life

10+ years

5-9 years

1-4 years

Less than one year

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If you would like to be entered into the drawing for the $25 gift certificate, please click this link to provide contact information. It will not be associated to this answer form in any way.

Thank you for your help in shaping future programming!

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