Air Health and Safety - Community Feedback Survey

Please take a few minutes to give us your thoughts about Air-Health and Safety in the Winnebago community. Your information is completely safe and anonymous. Taking this survey will help us to determine your needs and priorities for where we should focus funds and build Tribal air quality management capacity.

Question Title

* 1. Tribal Affiliation

Enrolled

Not Enrolled

Question Title

* 2. What county do you live in?

THURSTON

DIXON

BURT

DAKOTA

WAYNE

CUMMING

WOODBURY

MONONA

Other (please specify)

Question Title

* 3. What best fits you?

I live and work on the Reservation

I only work on the Reservation but live off Reservation.

I Live on the Reservation but work outside of it.

I only live on the Reservation

I come to the Reservation often but don't live or work here.