Park County Well-being Survey

The Park County Health Department is gathering information to understand how residents in the county connect with their local community. Information collected through this survey will be used to help the Health Department strengthen its programs to support community well-being and reduce isolation among community members. Your participation in this survey is voluntary and you may skip any questions. Your responses will only be viewed by the planning team and will be kept confidential. If you have any questions or problems when completing the survey, please contact Miriam or Sheryl at 406-222-4145.

1. In what community do you live?

2. For how long have you lived in your current community?

3. Are you a full-time resident of your current Park County community?

4. Please rate your level of agreement with the following statements:

Space Cell	Strongly disagree	Somewhat disagree	Somewhat agree	Strongly agree
I feel part of my community.	I feel part of my community.: Strongly disagree	I feel part of my community.: Somewhat disagree	I feel part of my community.: Somewhat agree	I feel part of my community.: Strongly agree
Our community fosters citizen connections and community pride.	Our community fosters citizen connections and community pride.: Strongly disagree	Our community fosters citizen connections and community pride.: Somewhat disagree	Our community fosters citizen connections and community pride.: Somewhat agree	Our community fosters citizen connections and community pride.: Strongly agree
I would like to see increased opportunities for community connections.	I would like to see increased opportunities for community connections.: Strongly disagree	I would like to see increased opportunities for community connections.: Somewhat disagree	I would like to see increased opportunities for community connections.: Somewhat agree	I would like to see increased opportunities for community connections.: Strongly agree
I feel that increasing the opportunities for community connections would better our community and the well-being of my neighbors.	I feel that increasing the opportunities for community connections would better our community and the well-being of my neighbors.: Strongly disagree	I feel that increasing the opportunities for community connections would better our community and the well-being of my neighbors.: Somewhat disagree	I feel that increasing the opportunities for community connections would better our community and the well-being of my neighbors.: Somewhat agree	I feel that increasing the opportunities for community connections would better our community and the well-being of my neighbors.: Strongly agree

5. Has the quality of your connection to community members changed during your time living in Park County?

6. Have any of the following obstacles made it hard for you to spend time connecting with others? Select all that apply.

7. Please select one answer for each question below:

Space Cell	Hardly ever	Some of the time	Often
How often do you feel that you lack companionship?	How often do you feel that you lack companionship?: Hardly ever	How often do you feel that you lack companionship?: Some of the time	How often do you feel that you lack companionship?: Often
How often do you feel left out?	How often do you feel left out?: Hardly ever	How often do you feel left out?: Some of the time	How often do you feel left out?: Often
How often do you feel isolated from others?	How often do you feel isolated from others?: Hardly ever	How often do you feel isolated from others?: Some of the time	How often do you feel isolated from others?: Often

8. What is your age?

9. Overall, which one of the following best describes how well you are managing financially these days?

10. Do you live alone or with other people?

11. Do you work or volunteer outside the home?

12. In addition to this survey, the Park County Health Department will be conducting interviews with community members. Would you be interested in participating in a follow-up interview as part of this project?

13. Please enter your contact information so we can contact you to schedule an interview.

Name: Please enter an 'other' value for this selection.
Email: Please enter an 'other' value for this selection.
Phone: Please enter an 'other' value for this selection.
I prefer not to provide my name and contact information on this survey.
Please contact the Health Department at 406-222-4145, shopkins@parkcounty.org, or mskertich@parkcounty.org to schedule an interview.