___You understand what a concerns survey is
___You understand how a concerns survey is part of the concerns report method
___You understand the reasons why you might want to conduct a concerns survey
___You understand that a concerns survey should usually be done with a broad cross-section of the community as a whole
___You have considered the budget and decided what sort of resources and supplies you'll need to complete the survey
___You have put together a working group to develop the survey
___You have met with your working group to come up with survey items
___Invite selected decision makers to submit additional survey items
___You have prepared your survey questions, using two types of questions for every selected issue: how important the issue is to citizens and how much satisfaction citizens have with the community's efforts on the issue
___You have narrowed your list of survey items down to approximately 30
___You have decided what demographic information to ask for in the survey
___You have gathered the items you'll need to do a direct mailing
___You have completed the cover letter
___You have made enough copies of the survey, demographic sheet, and cover letter for each survey recipient
___You have prepared and stamped the two business-size envelopes for each person
___You have stuffed the envelopes that have the recipient's mailing address with all the survey material
___ If you want to track the surveys in any way, you have coded your envelopes
___You have mailed your surveys out, by bulk mail if possible
___You have considered whether to employ any other methods of distributing or collecting surveys
___You have gathered incoming surveys collected at participating site
___You have reviewed returned surveys, checking for incomplete surveys or those returned for having an improper mailing address
___You have secured a larger return, if necessary
___You have figured out the results by averaging the importance and satisfaction reported for each item or issue
___You have written a brief report summarizing the strengths and problems as well as an overall approval rating for the community based on the average satisfaction score for all items and identifying five to ten strengths and five to ten problems in terms of health risks, services, and public perceptions of health
___You have shared this information with your staff, gotten their feedback, and discussed whether any further surveying needs to be done before completing
___You have conducted a public meeting to discuss the results and brainstorm for solutions
___You have written a one-page narrative for each issue discussed by the group
___You have written a concerns report consisting of an executive memo, brief report, data table, the problem-solving discussion report, demographic data and other displays, and suggestions on how to use the report in the planning process