Pipeline Impact on Residents

Thank you for your time and willingness to take a brief survey about the pipeline. Your feedback is important. Summary of the results will be shared with the larger community to increase awareness of the impact of the pipeline on community members. Your individual responses will be anonymous as well as any direct quotes used. 

If you would like support, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357). This is a Treatment Referral Routing Service that is confidential and free, available in English and Spanish, for individuals and family members facing mental and/or substance use concerns. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.

Only one response can be input per IP address (Internet Provider).

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I am dealing with the ______ pipeline project(s). (check all that apply)

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* 1. I am dealing with the ______ pipeline project(s). (check all that apply)

Please indicate your location.

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* 2. Please indicate your location.

Approximately how many months have you been aware of the pipeline project?

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* 3. Approximately how many months have you been aware of the pipeline project?

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Approximately how many months have you been actively engaged in advocating for the community with regards to the pipeline?

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* 4. Approximately how many months have you been actively engaged in advocating for the community with regards to the pipeline?

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The distance of the pipeline from my:

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* 5. The distance of the pipeline from my:

  less than 100 feet 100-1,000 feet 1,000-2,000 feet more than 2,000 feet n/a
Home
School
Workplace
Since learning of the pipeline project, I have been more stressed.

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* 6. Since learning of the pipeline project, I have been more stressed.

Since learning of the pipeline project, I have experienced sleep difficulties.

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* 7. Since learning of the pipeline project, I have experienced sleep difficulties.

My community has been actively engaged in educating themselves about the pipeline project.

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* 8. My community has been actively engaged in educating themselves about the pipeline project.

I have nightmares about the pipeline dangers.

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* 9. I have nightmares about the pipeline dangers.

Since learning of the pipeline project, my appetite has changed.

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* 10. Since learning of the pipeline project, my appetite has changed.

Since learning about the pipeline project, I have felt more irritable or angry.

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* 11. Since learning about the pipeline project, I have felt more irritable or angry.

Since learning of the pipeline project, I have had more frequent arguments with friends & loved ones.

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* 12. Since learning of the pipeline project, I have had more frequent arguments with friends & loved ones.

I have been drinking alcohol or using mood altering substances to cope with the difficulties regarding the pipeline.

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* 13. I have been drinking alcohol or using mood altering substances to cope with the difficulties regarding the pipeline.

I have been feeling depressed since learning about the pipeline.

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* 14. I have been feeling depressed since learning about the pipeline.

I have been feeling anxious since learning about the pipeline.

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* 15. I have been feeling anxious since learning about the pipeline.

Family/friends have told me I talk about the pipeline too much.

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* 16. Family/friends have told me I talk about the pipeline too much.

The more information I learn about the pipeline, the more hopeless I feel.

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* 17. The more information I learn about the pipeline, the more hopeless I feel.

I am concerned/worried about my property value due to the pipeline.

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* 18. I am concerned/worried about my property value due to the pipeline.

I feel that my elected officials have not advocated for my safety.

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* 19. I feel that my elected officials have not advocated for my safety.

I have support from people I can talk to about pipelines.

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* 20. I have support from people I can talk to about pipelines.

I know what to do in the event of a pipeline leak or explosion.

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* 21. I know what to do in the event of a pipeline leak or explosion.

Please indicate your gender

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* 22. Please indicate your gender

Are there children living in your home?

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* 23. Are there children living in your home?

Please indicate your age in years. 

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* 24. Please indicate your age in years. 

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Please use this space to provide any additional comments you have about how the pipeline project has impacted your life. 

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* 25. Please use this space to provide any additional comments you have about how the pipeline project has impacted your life. 

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