Emotional Wellness Survey 
Chaffee County Public Health is gathering information to better understand our community's emotional wellness.  We are also seeking to understand what are the barriers and opportunities in Chaffee County for emotional wellness.  Please help us serve our community better by taking some time to take this survey, which should take 10 minutes or less.

We recognize the sensitive nature of these questions.  All answers are completely anonymous and you do not need to answer any questions you are not comfortable with. All data collected will be kept private and secure. This information will not be used for discriminatory purposes, but rather will be used to help us better understand how to serve the behavioral health needs of our community.
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Demographic questions
Demographic information (age, gender, ethnicity, etc) allows us to better understand certain background characteristics of the people we are trying to reach.  The demographic data we gather in this survey will help us know whether we reach a representative sample of people in Chaffee County.  

For more information on gender and sexual orientation definitions check out this website: CLICK HERE 
What category best describes your age group? 
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What is your race?
What is your gender identity (select all that apply).  
What is your sexual orientation (select all that apply)
Where do you live?
How are you feeling today?
Clear selection
What is causing you to feel this way? 
What can this community do to better support you?
Do you feel this community offers accessible mental health care? 
Clear selection
Is there anything else that you would like us to know about you or your community's emotional wellness?
Thank you for your time. 

For information regarding community resources, includes mental health resources, 
please visit: chaffeeresources.com

In need of immediate support? Contact:
Colorado Crisis Hotline: (884)493-8255 or text "Talk" to 38255
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