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Ohio DPC Services Provider/Partner Survey for Health Equity

Thank you for participating in this survey. Your answers are helping us understand the barriers and challenges to providing disaster or emergency health services to people with disabilities. Names are not collected; your data will not be associated with your name in any way.

1. Do you provide services to Adams, Brown, Butler, Clinton, Clermont, Hamilton, Warren, or Highland County residents? *This question is required.

2. What zip code is your agency/business located in? *This question is required.