2023 Rogers Park Healthy Chicago Equity Zone Community Survey
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This survey is completely anonymous and no identification information will be collected. Your responses will be used by local community organizations to improve access to services in Rogers Park over the next three years.


Do you understand and agree?


 *
What is your ZIP code?
Clear selection
How long have you lived in your community?
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Which language(s) do you prefer to speak?
How do you describe your race/ethnicity?
What is your age?
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What is your gender identity?
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Are there children in your household between the ages of 0-5 years old?

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When you are required to fill out a race or ethnicity checkbox, how do you answer? Please circle only one.
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Does your family receive any of the following: SNAP/Link card, TANF, WIC, Medicaid, free or reduced school lunch?

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What is a current concern for you and your family, living in your community?


What would you like to see the community do to provide a solution to your concern from the previous question?
In what way(s) would you be willing to support this work?
What would allow you to live a safe, happy, and healthy life?

In the past year, have you or anyone in your household had trouble getting or paying for any of the following when it was really needed?

Yes
No
Health insurance
Medications
Legal services
Phone
Childcare
Dental care
Birth control
Housing you can afford
Utilities
Mental health care
Food
Medical care
Clothing
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If you were unable to access any of the services from the previous question, please describe the reason(s):
Please choose up to five of the following topics that are priorities for improvement in the community in the next year (leave the rest empty).
First Choice
Second Choice
Third Choice
Fourth Choice
Fifth Choice
Maternal and infant health
Legal services
Health insurance
Having services provided in a language you understand
Dental services
Food access
Getting a job
Access to birth control
Access to mental health services
Housing stability
Fair wages
Childcare
Access to exercise/physical activity
Root causes of violence/crime
After school programs
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