Fundy and Kings area Community Health Needs Assessment

1.

I would like to have my voice heard through:

* required

A focus group with six to 10 other people

A 1-on-1 talk over the phone

A 1-on-1 talk in person

2.

I am interested in sharing my voice as:

* required

Parents with young children

Youth

People living with any kind of disability

People who identify as 2SLGBTQIA+

Newcomers to the area

People living with financial uncertainty

Young adults - not in education, employment or training

Women in menopause

Les personnes en situation de précarité financière

Other (please specify)

3.

Last name

* required

Maximum 255 characters

0/255

4.

First name

* required

Maximum 255 characters

0/255

5.

Please provide you phone number

* required

Maximum 255 characters

0/255

6.

Please provide your email address

* required

Maximum 255 characters

0/255

7.

How did you hear about the CHNA taking place in your area?

* required

Maximum 255 characters

0/255

8.

I live in the area of:

Butternut Valley area (Studholm Parish, Cardwell, Johnston)

Fundy/St Martins (including Simmonds)

Hammond area

Hampton area

Quispamsis/Rothesay area

Sussex area

Valleywaters area (Norton)