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* 1. Have you ever experienced or been impacted by a natural disaster?

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* 2. If yes, Which of these natural hazards have you experienced or been impacted by? (Check all that apply.)

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* 3. How concerned are you about the possibility of your community being impacted by each of these natural hazards? (Check the corresponding circle for each natural hazard.)

  Not Concerned Somewhat Concerned Very Concerned
Dam/levee failure
Drought/Heat Wave
Earthquake
Flood
Hurricane
Nor'easter
Thunderstorm/Lightning/Hail
Tornado
Wildfire
Winter weather

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* 4. In your opinion, which of the following categories are most susceptible to natural hazards in your community? (Rank the community assets in order of vulnerability, 1 being most vulnerable and 6 being least vulnerable.) Please note, the list will automatically re-order itself as you make your selections. You can also drag and drop the items on the list to reorder them.

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* 5. How important is each of the following specific community assets to you? (Check the appropriate circle for each asset.)

  Not Important Not Very Important Neutral Somewhat Important Very Important
Airports
Colleges/Universities
Day Care and Elder Care Facilities
Emergency Operations Centers
Emergency Shelters
Fire, Police and EMS Stations
Historic Buildings
Hospitals and Medical Facilities
Local Businesses
Major Roads and Bridges
Parks and Recreation
Schools (K-12)
Town Hall/Courthouse

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* 6. Natural hazards can have a significant impact on a community, but planning for these types of events can help lessen the impacts. Please tell us how important each statement is to you by checking the appropriate circle for each.

  Not Important Not Very Important Neutral Somewhat Important Very Important
Protecting private property
Protecting critical facilities (for example, hospitals, police stations, fire stations, etc.)
Preventing development in hazard areas
Enhancing the function of natural features (for example, streams, wetlands, etc.)
Protecting historical and cultural landmarks
Protecting and reducing damage to utilities
Strengthening emergency services (for example, police, fire, ambulance)
Promoting cooperation among public agencies, citizens, non-profit organizations, and businesses

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* 7. What are some steps that you and/or your local government could take to reduce or eliminate the risk of future natural hazard damages in your neighborhood?

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* 8. What are the most effective ways for you to receive information about how to make your home and neighborhood more resistant to natural hazards?

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* 9. Is your home located in a floodplain?

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* 10. Do you have flood insurance?

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* 11. If “No,” why not?

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* 12. In the following list, please check the activities that you have done in your household, plan to do in the near future, have not done, or are unable to do. (Please check one response for each preparedness activity.)

  Have Done Plan To Do Not Done Unable To Do
Attended meetings or received written information on natural disasters or emergency preparedness?
Talked with members in your household about what to do in case of a natural disaster or emergency?
Developed a “Household/Family Emergency Plan” in order to decide what everyone would do in the event of a disaster?
Prepared a “Disaster Supply Kit” (stored extra food, water, batteries or other emergency supplies)?
In the last year, has anyone in your household been trained in First Aid or Cardio-Pulmonary Resuscitation (CPR)?
Prepared your home by installing smoke detectors on each level of the house?
Discussed or created a utility shutoff procedure in the event of a natural disaster?

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* 14. How long have you lived in the Tar River Region?

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* 15. What type of building do you live in?

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* 16. Additional Comments

0 of 16 answered
 

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