Household Chemical Roundup Comment and Survey Form (2009)
 
Tri-County Health Department welcomes your comments and suggestions regarding the Household Chemical Roundups. Your feedback will help us improve our program to better serve you and other residents.
Comment Form and Survey Instructions:

Answer the questions on each page, then click the " Next >> " button at the bottom of the page to go to continue. All questions (except the first) are optional. You may go back at any time by clicking on the " << Prev " ("previous") button.

On the last page, click the "Done >>" button to submit the your information and return to the Tri-County Health Department Household Chemical Roundup website. You may quit the survey at any time by closing your web browser window.
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1. Which Roundup did you attend?

2. Let us know about your experience at the Household Chemical Roudup by telling us whether you agree or disagree with the following statements. Please answer using the 9-point rating scale where 9 means "completely agree" and 1 means "completely disagree."

 disagree completelydisagree somewhat neither agree nor disagreeagree somewhat agree completelyN/A
I was able to dispose of all of my household hazardous waste.
The event staff were friendly and helpful.
The event was well organized.
I was, overall, satisfied with the service I received.
The Roundup was in a convenient location.

3. How did you hear about this Household Chemical Roundup? Please check all that apply.

4. Why did you use the service? Please check all that apply.

5. Is this the first time you've participated in a Household Chemical Roundup?

6. Other comments about your exerience at the Household Chemical Roundup: