Community Health Needs Assessment
The Meadville Medical Center & Titusville Area Hospital are conducting this survey to understand what the community needs related to cancer and cancer screening tests.
We need to hear from you. Please take 10 minutes to complete this survey.
This survey will not ask for your name, address or other identifiable information. You do not have to answer any question that you do not feel comfortable answering. All information recorded through this survey will remain confidential.
What is your zip code?
If you live in Meadville, in what neighborhood?
How old are you?
What is the highest level of school do you have?
Some high school
High school diploma/GED
Do you have health insurance?
No, I do not have insurance
Yes, I have private insurance
Yes, I have Medicaid
Yes, I have Medicare
Do you have one person who you think of as your personal doctor or healthcare provider (doctor, nurse, PA)?
When you are sick or injured where do you go FIRST for care or a diagnosis?
A private doctor's office
Walk-in health center (like MEDExpress)
Hospital emergency room (ER)
Where do you get most of your health information?
Are you a current smoker or have you smoked cigarettes in the past?
Yes, I am currently a smoker
I used to smoke, but have quit
I have never smoked
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This form was created inside of Allegheny College.