Shared CHNA Feedback Form 

The feedback provided on this form will go to the Maine CDC. If you are providing feedback for Central Maine Health Care, MaineGeneral Health or any other hospital system, it will be forwarded to contacts within that hospital.

If you wish to receive a response to your feedback, please be sure to leave your contact information. Generally, we try to respond within 10 business days, but it is helpful to know any dates by which you need a response. If you are seeking additional data, please use the Maine CDC’s data request form on this website:

Please note that if you are providing feedback on a Health Improvement Plan or Implementation Strategy, please use the HIP form.


2.If you are responding to a CHNA report for a particular county or district, please indicate which one:



5.What data was missing?

6.What significant health needs should hospitals and public health agencies address in the next three years?

7.What other feedback do you have about the Shared CHNA?

8.What questions do you have about the Shared CHNA?