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Community Health Survey
Thank you for taking the time to take this anonymous survey! It should only take about 15 minutes, and the Edgecombe County Health Department will use what you say to improve the health care services offered to you and your community.
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What is your age?
17 or younger
18-29
30-39
40-49
50-59
Over 60
Clear selection
What is your gender?
Female
Male
Other:
Clear selection
What is your race?
American Indian/Alaska Native
Asian
Black/African American
Hispanic/Latino/a
Native Hawaiian or other Pacific Islander
White
Other:
Clear selection
What is the highest level of school you have completed or the highest degree you have received?
Less than a high school diploma
High school diploma or GED
Some college but no degree
Associate's degree (2-year degree)
Bachelor's degree (4-year degree)
Graduate degree (Masters, PhD, etc.)
Clear selection
What is your employment status right now?
Employed full time (40+ hours/week)
Employed part time (less than 40 hours/week)
Student
Retired
Unemployed
Self-Employed
Unable to work
Clear selection
In what part of Edgecombe County do you live right now?
Conetoe
Leggett
Macclesfield
Pinetops
Princeville
Rocky Mount
Sharpsburg
Speed
Tarboro
Whitakers
I don't live in Edgecombe County
Clear selection
What is your relationship status right now?
Single (never married)
Married
Widowed
In a domestic partnership
Divorced
Clear selection
What is your yearly household income?
Below $10,000
$10,000-$50,000
$50,000-$100,000
$100,000-$150,000
Over $150,000
Clear selection
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