You can always press Enter⏎ to continue
Neighborhood HealthSource 2026 STI Awareness Survey
Thank you for taking the survey!
8
Questions
START
1
Have you heard about or visited our clinics?
*
This field is required.
Neighborhood HealthSource Clinics has 4 locations. You may have heard our clinics referred to as Central Clinic, Fremont Clinic, Sheridan Clinic, and North Metro Clinic.
YES
NO
Previous
Next
Submit
Press
Enter
2
If you said
YES
, please select the clinic(s) you have heard of or visited. If you said
NO
, please skip this section by clicking next.
Select all that apply.
Central Clinic - 2301 Central Ave NE
Sheridan Clinic - 342 13th Ave NE
Fremont Clinic - 3300 Fremont Ave N
North Metro Clinic - 10081 Dogwood St NW, Suite 100
Previous
Next
Submit
Press
Enter
3
Take a look at this picture!
Previous
Next
Submit
Press
Enter
4
The picture...
*
This field is required.
.
Not at All
Somewhat
Most Definitely
Catches my attention
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Has the information I need about walk-in hours
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Clearly communicates that there are payment options for walk-in hours
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Makes me want to use this service
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Catches my attention
Has the information I need about walk-in hours
Clearly communicates that there are payment options for walk-in hours
Makes me want to use this service
Not at All
Row 0, Column 0
Somewhat
Row 0, Column 1
Most Definitely
Row 0, Column 2
Not at All
Row 1, Column 0
Somewhat
Row 1, Column 1
Most Definitely
Row 1, Column 2
Not at All
Row 2, Column 0
Somewhat
Row 2, Column 1
Most Definitely
Row 2, Column 2
Not at All
Row 3, Column 0
Somewhat
Row 3, Column 1
Most Definitely
Row 3, Column 2
1
of 4
Previous
Next
Submit
Press
Enter
5
I know where I can get ______ care/help for myself or someone I know
*
This field is required.
Yes
No
Yes
No
Yes
No
Yes
No
STI testing
Birth control
General medicine
Health insurance application
STI testing
Birth control
General medicine
Health insurance application
Yes
No
Yes
No
Yes
No
Yes
No
1
of 4
Previous
Next
Submit
Press
Enter
6
Where would you go to look for information about a clinic or health service?
*
This field is required.
Select the one you would most likely use.
Google
Instagram
Facebook
TikTok
Newspaper
Radio
Other
Previous
Next
Submit
Press
Enter
7
How can we improve communication of our services?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
8
Want to be entered into a raffle prize drawing? Fill out this section!
By providing your name and phone number, you consent to Neighborhood HealthSource staff to calling and leaving a voicemail in case you win the raffle prize. All information are confidential and only available to NHS staff. Raffle prize winners will be contacted on Monday, May 11th, 2026
Please enter your FIRST name and LAST initial.
Please enter the PHONE NUMBER you would like to be contacted at.
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
8
See All
Go Back
Submit