This survey is being used by the IL-IN-WI Regional Catastrophic Planning Team (RCPT) to understand your household’s considerations of and actions towards being prepared for a natural disaster or emergency. The survey helps us assess household preparedness for disasters throughout certain regions of IL-IN-WI and could help improve governmental, non-governmental and private coordination of preparedness and risk reduction activities within your community. We appreciate you taking a few minutes to complete this survey.

* 1. Please provide your name, County and zip code.

* 2. What disasters or emergencies are currently the highest priority to you and your household? Will you please rank the following, where 10 indicates high priority and 1 indicates low priority.

  1 2 3 4 5 6 7 8 9 10
Earthquake
Extreme Heat
Flood
Fire
Food Borne Illness
Pandemic Influenza
Thunderstorm
Tornado
Winter Storm
Chemical or Hazardous Material Incident
Cyber Crime
Nuclear Power Plant Emergency
School or Workplace Violence
Terrorist Attack
Radiological Attack

* 3. Have there been any disasters in the news that have changed how you ranked the previous list of disasters? If so, what were those disasters?

* 4. In the last 3 months, did you seek additional information about being prepared? If so, what motivated you to seek additional preparedness information?

* 5. In the last 3 months, where did you go for additional preparedness information?

* 6. Did the website or other information source provide you with the information you were looking for?

* 7. Did you take any steps to be prepared in the last 3 months? If so, what steps did you take?

Additional information that will help you and your family increase preparedness can be found on the next page, and by visiting www.gearupgetready.org.
Report a problem

T