Sample CHNA Survey Questions - Good Healthy SD - goodandhealthysd 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by reviewing the 'Health Status' section. Here, you will answer questions about your general health and any chronic conditions. Select the appropriate response for each question.
3. Move on to the 'Quality of Life' section. Input the number of days in the past month that your physical or mental health was not good, using the provided fields.
4. In the 'Preventive Services' section, indicate whether you have had various health screenings like mammograms or Pap tests. Be sure to specify how long ago these tests were conducted.
5. Continue through sections on 'Access to Care', 'Health Behaviors and Risk Factors', and 'Social Determinants of Health'. Fill in your responses accurately based on your personal experiences.
6. Once all sections are completed, review your answers for accuracy before submitting the form.

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