Enter the HEAL Prize Drawing

Finished the Community Health Equity Survey? Complete this short form to enter HEAL Collaborative's prize drawing. Your prize entry is separate from the anonymous DPH survey. Please do not upload or share any survey answers.

First name

Last name

Phone

What community do you live in?

Gardner

Winchendon

Other

If other, Enter city or town

How did you complete the survey?

At a participating community location.

On my own

Participating Community Location

Upload Your Survey Completion Screenshot. Upload a screenshot showing the final DPH “Thank you for your time and for sharing your experiences with us!” page. Please do not upload screenshots of your survey answers.

I confirm that I completed the 2026 Community Health Equity Survey. I understand that my HEAL prize drawing entry is separate from the Massachusetts DPH survey and that HEAL does not receive my survey responses.