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Take a Step Follow-Up Survey
Please fill out this brief survey so we may continue to move towards a healthier community.

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Question
Response
Which kit did you receive?









Where did you receive your toolkit?






Was the information in the kit helpful?
   

Please rate the material in the kit:





Did you "Take a Step to Health" and make a change?
   

Do you feel an increase in your overall well-being?
   

Would you have made this change if you had not received this toolkit?




Did you recommend this project to others?




What is your county of residence?




What is your gender?



What is your age group?






Number of children living in your household Ages 0-5:






Number of children living in your household Ages 6-18: