Thank you for choosing to participate in the Eating Fish Safely survey.  This survey will be collected by your Tribal Environmental Director and will not be available through by any other entity.  The partner Tribes are conducting this survey to secure the safety of aquatic resources and water quality.   Your name, personal information, and individual results will be held internally and separately from your results.  Answers to these questions will be released in aggregate form only.  

To further guard your privacy, we will not be asking for your name or collecting any personal information.  However, you may provide it as the end of this survey if you want to be available for follow-up questions.

This survey will take about 15 minutes. 

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* 1. SURVEY #: (Please have survey administrator fill out if not already)

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* 2. Date: 

Date

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* 3. Location of Survey:

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* 4. What is your Tribal Affiliation(s)?

The following questions will ask for information on your gender and age because the most at-risk populations for exposure are “children and females under the age of 46.”

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* 5. What is your gender?

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* 6. What is your age?

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* 7. Have you ever participated in a “Fish Consumption Survey”?

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* 8. If yes to the question above, which one? Or both?

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* 9. Conducted by which organization?

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 17% of survey complete.

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