Needs Assessment Survey

Please take a moment to share your views with us in order to help us set priorities for pregnant women, infants, mothers, and children in Sarasota County.

The Florida Department of Health provides resources to Sarasota County to support a system of care in maternal and child health. Today, we are asking you as part of a county-wide needs assessment to respond to the following items related to local priorities. Thank you for your feedback. Your opinions will help shape the allocation of more than $700,000 annually to best meet the needs of our mothers, babies, and young families.

1. With regard to pregnant women and/or mothers, what in your opinion is the greatest unmet need in our community?
   
2. With regard to infants and children, what in your opinion is the greatest unmet need locally?
   
3. Please consider the pressing needs and emergent issues for mothers and babies in Sarasota Counted listed below and check only three (or add your own in the space provided) to identify the top priorities.
   

   Access to health care for children Asthma in children younger than five Blood lead levels in children ages 1 - 6 Breastfeeding Child abuse Childhood obesity Children with special health care needs Chronic disease in women of childbearing age Dental caries Food-borne illness Health insurance coverage Low birth weight/prematurity Immunizations

   Perinatal depression Perinatal transmission of HIV Physical fitness in children Preconception/interconception care Substance abuse Sudden Infant Death Syndroms (SIDS) Teen pregnancy prevention Tobacco use Unintended pregnancy Quality day care for children younger than 5 Other Other Other

4. Please use the space below to describe briefly any suggested solutions for the issues you have identified above.
   
5. Optional

   Your name
   Your email address
   Your phone number

Feel free to contact us if you would like to receive a copy of our completed needs assessment. Thank you!