Introduction and Purpose

This survey is designed to help the Hazard Mitigation Steering Committee identify the community’s concerns about natural and human-caused hazards, to better understand community needs in reducing risk and loss from such hazards. It should be completed by an adult, preferably the homeowner or the head of the household. Please take a few minutes to complete this survey. All individual responses are strictly confidential and are for research purposes only.

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* 1. Please provide your ZIP Code:

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* 2. Please provide the name of your community or location (city):

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* 3. Are you within city limits?

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* 4. Do you have Internet access?

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* 5. Do you own or rent?

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* 6. How concerned are you about the following threats affecting your community? Please give each a priority rating as follows:

  Not Concerned Somewhat Concerned Moderately Concerned Very Concerned
Floods
Levee Failure
High Winds
Dam Failure
Health Alert / Mass Disease
Landslides/Mudslides
Earthquake
Biological (plant or animal)
Severe Storm
Hazardous Materials
Transportation Loss
Fire
Telecommunications Failure
Radiological Incident
Public/Civil Disorder
Special Events
Terrorism
Utilities Interruption
Environmental (drought, air pollution, etc.)
Volcanic Eruption

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* 7. What is the most effective way for you to receive information about how to make your household and home safer from natural disasters? (Please check all that apply)

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* 8. How aware are you of the natural hazards that could affect your home?

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* 9. In the following list, please check those activities that you or someone in your household, have done, plan to do in the near future, have not done, or are unable to do. (Please check one answer for each preparedness activity.)

  Have Done Plan To Do Not Done Unable To Do
Attended meetings or received written information on natural disasters or emergency preparedness?
Talked with family members about what to do in case of a disaster or emergency
Developed a “Household/Family Emergency Plan” in order to decide what everyone would do in the event of a disaster?
In the last year, has someone in your household been trained in First Aid or Cardio-Pulmonary Resuscitation (CPR)?

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* 10. Natural and human-caused disasters can have a significant impact on a community but planning for these events can help lessen the impact. The following statements will help us determine community priorities in planning for these hazards. Please tell us how important each one is to you.

  Not Important Not Very Important Neutral Somewhat Important Very Important
Protecting private property
Protecting critical facilities (hospitals, transportation networks, fire stations)
Preventing development in hazard areas
Protecting natural environment
Protecting historical / cultural landmarks
Promoting cooperation among public agencies, citizens, non-profit organizations and businesses
Protecting and reducing damage to utilities
Strengthening emergency services (police, fire, ambulance)

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