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* 1. Please check where you live:

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* 2. How many people are in your household?

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* 3. How many children (if any) are in:

*Enter a number in the field (use 0 if none)

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* 4. Which diseases do you think are spread by mosquitoes in Texas? (check all that apply)

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* 5. Is mosquito control an important issue to you?

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* 6. In the last 30 days, have you or a member of your household used mosquito repellent?

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* 7. If you answered no to question #6, why?

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* 8. Do you have any of the following in your yard or by your house? (check all that apply)

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* 9. Please rank in order from 1-6 (1 being the best), trusted sources of mosquito-borne disease information:

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* 10. What can you do to protect yourself from mosquito-borne diseases? (select all that apply)

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* 11. To protect yourself from mosquito-borne diseases, how often should you apply insect repellent?

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