CHRP Resources Survey

CHRP Questionnaire

Community Health Resources Project - Institute for Health Logistics & Analytics, Georgia Southern University
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
What health resources matter most in YOUR community?

This questionnaire invites you to share your valuable information about health-related resources and services available in your community.

Your input matters! By sharing your knowledge, you'll help us create a comprehensive picture of the resources that contribute to the physical, mental, and social well-being of community members.

We're looking for information on a wide range of resources which may include:
- Food and Nutrition
- Healthcare
- Family Services
- Animal/Veterinary Services
- Parks and Recreation
- Emergency/Crisis Services
No piece of information is too small! Every detail you provide helps us better understand and highlight the diverse ways your community supports health and well-being.

To learn more about us, this project, and the other great things we do, check out our website and follow our updates on Facebook.

Resource 1
Select the type of resource you would like to provide information about.
What would you like to talk about regarding this community resource?

Discuss the strengths of this resourceHighlight a story about this resource
What strengths do you see in this resource in your community?
What story would you like to share about this resource in your community?
Tell us more about this resource
Name of the resource
Describe how you use the resource and include any other services they provide.
How do you connect with this resource (e.g., website, phone)?
Who referred you to this resource? Or how did you hear about (or come to know) this resource?
Would you like to provide more information about another resource?

YESNO

Resource 2
II. Select the type of resource you would like to provide information about.
II. What would you like to talk about regarding this resource?

Discuss the strengths of this resourceHighlight a story about this resource
II. What strengths do you see in this resource in your community?
II. What story would you like to share about this resource in your community?
Tell us more about this resource
II. Name of the resource
II. Describe how you use the resource and include any other services they provide.
II. How do you connect with this resource (e.g., website, phone)?
II. Who referred you to this resource? Or how did you hear about (or come to know) this resource?
II. Would you like to provide more information about another resource?

YESNO

Resource 3
III. Select the type of resource you would like to provide information about.
III. What would you like to talk about regarding this community resource?

Discuss the strengths of this resourceHighlight a story about this resource
III. What strengths do you see in this resource in your community?
III. What story would you like to share about this resource in your community?
Tell us more about this resource
III. Name of the resource
III. Describe how you use the resource and include any other services they provide.
III. How do you connect with this resource (e.g., website, phone)?
III. Who referred you to this resource? Or how did you hear about (or come to know) this resource?
III. Would you like to provide more information about another resource?

YESNO

Resource 4
IV. Select the type of resource you would like to provide information about.
IV. What would you like to talk about regarding this community resource?

Discuss the strengths of this resourceHighlight a story about this resource
IV. What strengths do you see in this resource in your community?
IV. What story would you like to share about this resource in your community?
Tell us more about this resource
IV. Name of the resource
IV. Describe how you use the resource and include any other services they provide.
IV. How do you connect with this resource (e.g., website, phone)?
IV. Who referred you to this resource? Or how did you hear about (or come to know) this resource?

CHRP Questionnaire