Take The First Step Preparedness Survey

	Yes	No
I have placed a sturdy pair of shoes under my bed to protect my feet if an earthquake takes place at night.	I have placed a sturdy pair of shoes under my bed to protect my feet if an earthquake takes place at night. Yes	I have placed a sturdy pair of shoes under my bed to protect my feet if an earthquake takes place at night. No
I have emergency supplies in my car.	I have emergency supplies in my car. Yes	I have emergency supplies in my car. No
I have included prescription medicines in my emergency supplies.	I have included prescription medicines in my emergency supplies. Yes	I have included prescription medicines in my emergency supplies. No
I have included copies of my important documents, including insurance information, in my emergency supplies.	I have included copies of my important documents, including insurance information, in my emergency supplies. Yes	I have included copies of my important documents, including insurance information, in my emergency supplies. No
Each member of my family has the phone number of our “Out of State Emergency Contact” in case we cannot reach each other with a local phone call during a disaster.	Each member of my family has the phone number of our “Out of State Emergency Contact” in case we cannot reach each other with a local phone call during a disaster. Yes	Each member of my family has the phone number of our “Out of State Emergency Contact” in case we cannot reach each other with a local phone call during a disaster. No
I have stored supplies of food and water for each member of my family, including my pets, to sustain us after a disaster.	I have stored supplies of food and water for each member of my family, including my pets, to sustain us after a disaster. Yes	I have stored supplies of food and water for each member of my family, including my pets, to sustain us after a disaster. No
I have signed up for Kitsap Emergency Management’s Alert and Warning notifications at http://www.kitsapdem.org/	I have signed up for Kitsap Emergency Management’s Alert and Warning notifications at http://www.kitsapdem.org/ Yes	I have signed up for Kitsap Emergency Management’s Alert and Warning notifications at http://www.kitsapdem.org/ No
I have signed up for inclement weather and road report updates from Kitsap County http://www.kitsapgov.com/	I have signed up for inclement weather and road report updates from Kitsap County http://www.kitsapgov.com/ Yes	I have signed up for inclement weather and road report updates from Kitsap County http://www.kitsapgov.com/ No

Yes

I have placed a sturdy pair of shoes under my bed to protect my feet if an earthquake takes place at night.

I have placed a sturdy pair of shoes under my bed to protect my feet if an earthquake takes place at night. Yes

I have placed a sturdy pair of shoes under my bed to protect my feet if an earthquake takes place at night. No

I have emergency supplies in my car.

I have emergency supplies in my car. Yes

I have emergency supplies in my car. No

I have included prescription medicines in my emergency supplies.

I have included prescription medicines in my emergency supplies. Yes

I have included prescription medicines in my emergency supplies. No

I have included copies of my important documents, including insurance information, in my emergency supplies.

I have included copies of my important documents, including insurance information, in my emergency supplies. Yes

I have included copies of my important documents, including insurance information, in my emergency supplies. No

Each member of my family has the phone number of our “Out of State Emergency Contact” in case we cannot reach each other with a local phone call during a disaster.

Each member of my family has the phone number of our “Out of State Emergency Contact” in case we cannot reach each other with a local phone call during a disaster. Yes

Each member of my family has the phone number of our “Out of State Emergency Contact” in case we cannot reach each other with a local phone call during a disaster. No

I have stored supplies of food and water for each member of my family, including my pets, to sustain us after a disaster.

I have stored supplies of food and water for each member of my family, including my pets, to sustain us after a disaster. Yes

I have stored supplies of food and water for each member of my family, including my pets, to sustain us after a disaster. No

I have signed up for Kitsap Emergency Management’s Alert and Warning notifications at http://www.kitsapdem.org/

I have signed up for Kitsap Emergency Management’s Alert and Warning notifications at http://www.kitsapdem.org/ Yes

I have signed up for Kitsap Emergency Management’s Alert and Warning notifications at http://www.kitsapdem.org/ No

I have signed up for inclement weather and road report updates from Kitsap County http://www.kitsapgov.com/

I have signed up for inclement weather and road report updates from Kitsap County http://www.kitsapgov.com/ Yes

I have signed up for inclement weather and road report updates from Kitsap County http://www.kitsapgov.com/ No

We want to help you get prepared.
The first 50 people to take the survey are eligible to receive a hand-cranked flashlight to add to their preparedness kit.
If you would like to receive the flashlight please enter your mailing information below.
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* 1. Please answer yes or no to each of the statements below.

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