Purpose: San Gabriel Valley Mosquito and Vector Control District is interested in resident's opinions about mosquito repellents. Thank you for taking time to fill out the survey. The results will help us provide better protection for your family and all of our residents.

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* 1. Email

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* 2. Your child's first and last name

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* 3. Please pick from the drop down menu your child's school, teacher, and class period (if applicable)

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* 4. Have you heard of any of the following active ingredients found in mosquito repellents: DEET, Picaridin, IR3535, or Oil of Lemon Eucalyptus?

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* 5. Do you use mosquito repellents with ANY of the following active ingredients: DEET, Picaridin, IR3535, or Oil of Lemon Eucalyptus?

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* 6. If you DO NOT use mosquito repellent, what would be a reason (check all that apply)?

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* 7. If you chose "other," please add a short description of your reason.

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* 8. How do you rate the health risks to you and your family of each of the following ingredients:

  Very risky Risky Neutral Safe Very Safe
Oil of Lemon Eucalyptus
IR3535
DEET
Picaridin
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