Caring for Populations: Community Windshield Survey Form

Directions: Please refer to the Milestone 1: Community Windshield Survey Guidelines and grading rubric found in Doc Sharing for specific instructions in order to complete the information below. This assignment is worth 150 points. Type your name above and your answers below directly on this form. Click Save as and save the file with the assignment name and your last name (e.g., “NR443 Windshield Survey Form_Smith”). When you are finished, submit the form to the Week 2 Caring for Populations: Windshield Survey Dropbox by the deadline indicated in your guidelines. Your Name: Date: Your Instructor’s Name: Criteria 1. Community introduction: Identify the community you will be using for this assignment. It should be the area where you live or the area surrounding your work setting. 2. Windshield survey a. vitality b. Indicators of social and economic conditions c. Health resources d. Environmental conditions related to health e. Social functioning f. Attitude toward healthcare 3. Conclusion: Provide a summary of your findings and your conclusion. What problems did you identify? 4. References: OPTIONAL: List any references that you cited.

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