---
title: Community Health Center Facility Siting Public Hearing Form Template | Paperform
description: Collect structured public comments on proposed health center locations with feedback on service coverage, transportation access, and community health priorities. Free template for government agencies.
url: "https://paperform.co/templates/community-health-center-facility-siting-public-hearing-form"
type: static
generatedAt: "2026-03-28T00:43:25.707Z"
---

[← Back to free form templates](/templates/)    ![Community Health Center Facility Siting Public Hearing Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/community-health-center-facility-siting-public-hearing-form.png)
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### Community Health Center Facility Siting Public Hearing Form

When local governments and health authorities propose new community health center facilities, public input is essential to ensure these vital resources truly serve the needs of residents. This **Community Health Center Facility Siting Public Hearing Form** makes it easy for citizens, healthcare advocates, and community organizations to submit structured comments on proposed facility locations, service areas, transportation accessibility, and health priorities.

#### Why Public Comment Matters for Health Facility Siting

Community health centers serve as critical access points for primary care, preventive services, mental health support, and specialized care—particularly for underserved populations. The location of these facilities directly impacts:

 - **Access to care:** Whether residents can physically reach the facility via public transit, walking, or driving
 - **Service equity:** How well the facility's service area addresses gaps in existing healthcare coverage
 - **Community health outcomes:** Alignment between facility services and the specific health challenges facing local residents
 - **Long-term sustainability:** Community support and utilization rates that determine facility success

Public hearing processes allow residents to voice concerns, highlight unmet needs, and ensure decision-makers have complete information before finalizing facility locations.

#### Streamline Public Participation with Paperform

Traditionally, public comment processes rely on in-person hearings, mailed letters, or generic email submissions that can be difficult to organize and analyze. This Paperform template modernizes the process by:

 - **Collecting structured feedback** on service area coverage, transportation barriers, and health priorities
 - **Capturing detailed location information** from commenters to map community sentiment geographically
 - **Enabling accessibility** for residents who cannot attend in-person hearings due to work schedules, mobility challenges, or childcare responsibilities
 - **Organizing responses** for easier review by planning commissions, health boards, and municipal decision-makers

#### Who This Form Serves

This template is designed for:

 - **Public health departments** conducting community needs assessments and facility planning
 - **Municipal planning departments** managing zoning applications and public hearing processes
 - **Federally Qualified Health Centers (FQHCs)** seeking community input on expansion or new facilities
 - **County health boards** evaluating proposals for clinic locations and service configurations
 - **Community development organizations** facilitating resident engagement in health infrastructure decisions

#### Key Features of This Template

**Commenter Information:** Captures name, contact details, and relationship to the community (resident, healthcare worker, business owner, etc.) to provide context for each submission.

**Facility Location Feedback:** Allows commenters to indicate support or opposition to the proposed location, with detailed reasoning about service area coverage, geographic accessibility, and gaps in existing healthcare infrastructure.

**Transportation & Access Analysis:** Collects specific feedback on transportation barriers, including public transit availability, parking concerns, walkability, and accessibility for elderly or disabled residents.

**Community Health Priorities:** Enables residents to identify the most pressing health needs in their area—from chronic disease management to mental health services, pediatric care, or substance abuse treatment—ensuring facility services align with community needs.

**Service Hours & Capacity:** Gathers input on preferred operating hours, evening/weekend availability, and capacity concerns to inform facility planning.

**Alternative Site Suggestions:** Provides space for commenters to recommend alternative locations or modifications that would better serve community needs.

#### Automate Your Public Comment Workflow

Once you've collected public comments through Paperform, you can streamline your review and analysis process using **Stepper** (stepper.io), Paperform's AI-native workflow automation tool:

 - **Automatically categorize comments** by sentiment (support/opposition), geographic area, or key themes
 - **Route submissions** to relevant department heads, planners, or health board members based on comment type
 - **Generate summary reports** aggregating feedback for presentation at public hearings or board meetings
 - **Send confirmation emails** to commenters acknowledging receipt and providing hearing dates
 - **Update project management tools** like Asana, Monday.com, or Notion with categorized feedback for review

For processes requiring formal acknowledgment or legal record-keeping, **Papersign** (papersign.com) can be used to send affidavits, disclosure forms, or official hearing participation certificates to commenters who need documentation of their submission.

#### Built for Government Transparency and Accessibility

Public sector organizations need forms that meet accessibility standards, protect data privacy, and maintain public trust. This template follows best practices for civic engagement forms:

 - **Clear, plain-language questions** that don't require technical or legal expertise
 - **Mobile-friendly design** ensuring residents can participate from any device
 - **Conditional logic** that adapts questions based on commenter responses, reducing form fatigue
 - **Secure data collection** meeting government data protection standards
 - **Accessible design** supporting screen readers and keyboard navigation

#### Integrate with Your Existing Systems

Paperform connects seamlessly with the tools government agencies and nonprofits already use:

 - **Send submissions to Google Sheets or Airtable** for collaborative review and analysis
 - **Push notifications to Slack or Microsoft Teams** when high-priority comments are received
 - **Sync with CRM systems** to maintain constituent communication records
 - **Export to Excel or PDF** for inclusion in official public hearing records
 - **Connect via webhooks** to custom government databases or case management systems

#### Encourage Meaningful Community Participation

Effective public comment processes don't just collect data—they foster genuine community engagement and trust in government decision-making. This form template helps you:

 - **Lower barriers to participation** by offering a convenient, 24/7 submission method
 - **Gather richer, more specific feedback** through structured questions that prompt detailed responses
 - **Demonstrate transparency** by making the comment process clear, accessible, and responsive
 - **Build community buy-in** for health infrastructure investments that reflect resident priorities

Whether you're a county health department planning a rural clinic expansion, a city planning commission reviewing a zoning variance for a community health center, or a nonprofit healthcare organization seeking input on facility locations, this Paperform template provides a professional, accessible foundation for meaningful public participation.

**Get started in minutes.** Customize the questions to match your specific proposal, add your agency branding, and share the form via your website, social media, email newsletters, or QR codes at community meetings. With Paperform's intuitive editor, you can adapt this template to any public comment process—from environmental reviews to land use decisions—without writing a single line of code.
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