This survey is intended to help Fort Bend County Health & Human Services (FBCHHS) create a database of apiaries within Fort Bend County.  In the event of a local Zika virus outbreak, aerial pesticide application may be used as one way to eliminate mosquitoes in the area of active transmission.  The Aedes species mosquito which transmits Zika is a daytime flyer, so pesticide application may need to take place during the day to be most effective; this means that bees may need to be kept within their hives or evacuated from the area prior to the pesticide application taking place.  We expect that if the decision to use aerial pesticides is made, the community would be given a minimum of three (3) days notice before operations begin and provided the name of the type of chemical to be used.

Participation in this registry is voluntary.  The information given will only be used to help FBCHHS contact apiary owners within an area targeted for aerial pesticide application, in response to a local Zika outbreak.  If you do not wish to participate in this registry, but still wish to receive the latest news releases from FBCHHS (including any announcements of aerial pesticide application), please Like/Follow us on Facebook, Twitter, and/or Nextdoor.

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* 1. Apiary/Farm/Business Name:

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* 2. Apiary Address:

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* 3. Apiary Latitude/Longitude (if known):

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* 4. Apiary Acreage:

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* 5. Apiary On-Site Phone Number(s):

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* 6. Apiary Email:

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* 7. Primary Contact Person Name:

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* 8. Primary Contact Phone Numbers:

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* 9. Primary Contact Address:

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* 10. Primary Contact Email:

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* 11. Secondary Contact Person Name:

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* 12. Secondary Contact Phone Numbers:

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* 13. Secondary Contact Address:

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* 14. Secondary Contact Email:

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* 15. Any additional information, questions, or comments:

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