County Household Questionnaire

Collect timely data about demographic changes in your county. Suggested users: regional agencies.




How long have you been a resident of [CountyName]?

How would you rate the overall quality of life in [CountyName]?

Excellent
Good
Average
Fair
Poor

How satisfied are you with the following services and facilities where you live?

Satisfied Somewhat satisfied Dissatisfied Not Applicable
Law enforcement
Fire protection
Ambulance service
Streets and roads
Historical preservation
Garbage disposal
Childcare and Prekindergarten education
K-12 education
Post high-school education (community college, university)
Town/village/city government services
County government services
Retail/service businesses
Job opportunities
Medical services (family doctor, clinic)
Dental services
Parks and recreation facilities
Motorized recreation
Non-motorized recreation

How important to you are the following reasons for living in [CountyName]?

Very Important Important Somewhat Important Not Important
Near employment
Reasonable cost of living
Quality of schools
Low crime rate
Outdoor recreation opportunities
Open spaces, hills and woods
Low taxes
Access to health care services
Affordable housing

Please identify your level of satisfaction for the following transportation resources in [CountyName].

Satisfied Somewhat Satisfied Dissatisfied Not Applicable
State and federal highways
County highways
Town/Village/City roads
Township roads
Bicycling lanes/trails
Motorized trails (ATV's)
Pedestrian/walking trails

Do you have any comments or concerns about transportation infrastructure?

Are there new services or improvements to existing services that you think should be provided?

How important is it to preserve the following types of cultural and historic resources in [CountyName].

High Priority Medium Priority Low Priority Not Applicable
Archeological sites
Buildings or structures with architectural or historic significance
Cemeteries
Scenic views

Are there any cultural or historic resources you are particularly concerned about preserving or restoring?

Are there other housing issues you are concerned about?

What do you like most about living in [CountyName]?




If you were talking to a county official about the five most important issues facing [CountyName] in the future, what issues would you identify?

Jobs and economic opportunity
Cost of living
Access to health care
Fire protection
Loss of farmland
Protection of natural resources
Quality of streets and roads
Affordable housing
Quality of schools
Government leadership
Crime
Public access to lakes, forests and other outdoor recreation
Property taxes
Affordable access to high speed internet
Out migration of young adults
Quality of available housing
Law enforcement and public safety
Flooding and drainage
Non-resident property owners

What is your age?

What is your gender?

Male
Female
Other (Please specify):