Dr House Questionnaire <form-template> <fields> <field type="header" subtype="h1" label="The Municipality of Louise is seeking public input regarding the future of the municipality built Doctor's house in the LUD of Pilot Mound. Your feedback will help inform our decision-making process." class="header"></field> <field type="select" label="1. Do you live in the LUD of Pilot Mound? " class="form-control select" name="select-1742588660977"> <option selected="true">Yes</option> <option value="option-2">No</option> </field> <field type="select" label="2. How long have you lived in this community? " class="form-control select" name="select-1742588708081"> <option selected="true">Less than 1 year</option> <option>1-5 years</option> <option>6-10 years</option> <option>More than 10 years</option> </field> <field type="select" label="3. What is your age group? " class="form-control select" name="select-1742588782954"> <option selected="true">Under 18</option> <option>18-34</option> <option>35-54</option> <option>55+</option> </field> <field type="header" subtype="h1" label="Awareness and Usage" class="header"></field> <field type="select" label="4. Are you aware that the municipality owns a house that was built with the intention to provide housing for a doctor?" class="form-control select" name="select-1742588882595"> <option selected="true">Yes</option> <option>No</option> </field> <field type="select" label="5. Do you believe having a designated doctor's house benefits the community? " class="form-control select" name="select-1742588928187"> <option selected="true">Yes</option> <option>No</option> </field> <field type="select" label="6. Have you or your family members ever interacted with a Doctor while they lived in this house?" class="form-control select" name="select-1742588962564"> <option selected="true">Yes</option> <option>No</option> </field> <field type="select" label="7. Are you aware of the last time that a Doctor rented the doctor's house? " class="form-control select" name="select-1742588998684"> <option selected="true">Yes</option> <option>No</option> </field> <field type="header" subtype="h1" label="Opinions on Keeping the Doctor's House" class="header"></field> <field type="select" label="8. Do you think the municipality should continue to provide housing for a potential local Doctor to live in?" class="form-control select" name="select-1742589043276"> <option selected="true">Yes</option> <option>No</option> </field> <field type="select" label="9. What do you see as the biggest benefits of maintaining the Doctor's house? (Select all that apply, hold ctrl on keyboard to select multiple answers)" class="form-control select" name="select-1743531485538" multiple="true"> <option value="Attracting and retaining doctors" selected="true">Attracting and retaining doctors</option> <option value="Ensuring medical professionals are available locally">Ensuring medical professionals are available locally</option> <option value="Supporting healthcare infrastructure">Supporting healthcare infrastructure</option> <option value="Preserving a municipal asset">Preserving a municipal asset</option> <option value="Other (Please specify below)">Other (Please specify below)</option> </field> <field type="textarea" label="9. Other" class="form-control text-area" name="textarea-1742482801481"></field> <field type="select" label="10. What concerns, if any, do you have about the municipality keeping the doctor's house? (Select all that apply, hold ctrl on keyboard to select multiple answers)" class="form-control select" name="select-1743531929787" multiple="true"> <option value="Cost to taxpayers" selected="true">Cost to taxpayers</option> <option value="Upkeep and maintenance expenses">Upkeep and maintenance expenses</option> <option value="Alternative uses for the property">Alternative uses for the property</option> <option value="Other (Please specify below)">Other (Please specify below)</option> </field> <field type="textarea" label=" Other" class="form-control text-area" name="textarea-1742483390617"></field> <field type="header" subtype="h1" label="Alternative Options" class="header"></field> <field type="select" label="11. If the municipality were to sell the house, and aside from agreed terms of repayment, what would you prefer the excess funds to be used for?" class="form-control select" name="select-1743534644026"> <option value="Housing projects in the LUD of Pilot Mound" selected="true">Housing projects in the LUD of Pilot Mound</option> <option value="Infrastructure improvements in the LUD of Pilot Mound">Infrastructure improvements in the LUD of Pilot Mound</option> <option value="Community programs">Community programs</option> <option value="Other (Please specify below)">Other (Please specify below)</option> </field> <field type="textarea" label="Other" class="form-control text-area" name="textarea-1742483774325"></field> <field type="textarea" label="12. Do you have any additional comments or suggestions? " class="form-control text-area" name="textarea-1742483853171"></field> <field type="header" subtype="h1" label="Thank you for taking the time to participate. Your input is valuable in making an informed decision for our community." class="header"></field> </fields> </form-template> Submit Submitting...
