KDHE Home - Health - CHES - Summary of Vital Statistics - 1998 Annual Summary of Vital Statistics - 1998 Data Users Survey


Data Users Survey

Center for Health and Environmental Statistics
Kansas Department of Health and Environment

Your input is more important than creating a web database to automatically record your responses.  Feel free to print out this form, fill it out, and mail or fax it back.  You may also use your browser's editor and enter your answers that way and e-mail a copy of the completed HTML file.  Click here for a PDF version of the form.  You'll need Adobe Acrobat Reader to view or print.

Your Organization
____1 Hospital ____ 2 Health Dept
____ 3 Private Company  ____ 4 Not-for-Profit 
____ 5 City Government  ____ 6 State Government 
____ 7 Federal Government ____ 8 Church 
____ 9 Professional Association  ____ 10 Individual 
____ 11 Foundation  ____ 12 School 
____ 13 University  ____ 14 Other (specify) ________________________
Your Position
____ 1 Administrator/Manager ____ 8 Consultant 
____ 2 Legislator/Council Member  ____ 9-Program Manager
____ 3 Nurse  ____ 10 Program Staff
____ 4 Medical Doctor  ____ 11 Safety Officer
____ 5 Planner ____ 12 Researcher 
____ 6 Data Analysis Staff ____ 13 Other(specify) _________________________
____ 7 Epidemiologist 
CHES Products used/received/seen (checking more than one is OK):
____ 1 Annual Summary of Vital Statistics ____ 2 Teenage Pregnancy Summary
____ 3 Perinatal Casualty Report ____ 4 Kansas Health Statistics Newsletter
____ 5 Vital Statistics Wallet Card  ____ 6 Occupational Injury/Illness Report
____ 7 Annual Census of Fatal Occupational Injuries ____ 8 Abortion Report
____ 9 Population Highlights  ____ 10 Age Adjusted Death Rates
____ 11 Zip Code Level Reports ____ 12 Special Reports (ad hoc queries)
____ 13 Adequacy of Prenatal Care Index ____ 14 Health Occupations Data
____ 15 Hospital Data ____ 16 Mailing Labels

____ 17 Others (please specify)
_______________________________________________________
CHES products you would like to use, receive, or see (more than one is OK):
____ 1 Annual Summary of Vital Statistics  ____ 2 Teenage Pregnancy Summary
____ 3 Perinatal Casualty Report ____ 4 Kansas Health Statistics Newsletter
____ 5 Vital Statistics Wallet Card ____ 6 Occupational Injury/Illness Report
____ 7 Annual Census of Fatal Occupational Injuries ____ 8 Abortion Report
____ 9 Population Highlights  ____ 10 Age Adjusted Death Rates
____ 11 Zip Code Reports ____ 12 Special Reports (ad hoc queries)
____ 13 Adequacy of Prenatal Care Index ____ 14 Health Occupations Data
____ 15 Hospital Data ____ 16 Mailing Labels

____ 17 Others (please specify)
_________________________________________________
Check all formats in which you are capable of using or receiving the Kansas information:
____ 1 CD-ROM ____ 2 Paper Copy
____ 3 Hardbound Book ____ 4 HTML (Internet)
____ 5 ascii text ____ 6 spreadsheet file
____ 7 diskette ____ 8 Electronic File Transfer
____ 9 Access from KDHE website ____ 10 Zip Disk
____ 11 Adobe Acrobat (PDF) ____ 12 Other (specify) ________________
Check the format you would most prefer to receive the information:
____ 1 CD-ROM ____ 2 Paper Copy
____ 3 Hardbound Book ____ 4 HTML (Internet)
____ 5 ascii text ____ 6 spreadsheet file
____ 7 diskette ____ 8 Electronic File Transfer
____ 9 Access from KDHE website ____ 10 Zip Disk
____ 11 Adobe Acrobat (PDF) ____ 12 Other (specify) ________________

Please feel free to add any comments on health data issues not addressed above. Your thoughts and concerns are important to us. Thanks.
Return to: KDHE Office of Health Care Information, 900 SW Jackson, Room 904, Topeka, KS, 66612  Fax (785)-368-7118
or e-mail to gcrawfor@kdheks.gov