Dear New Hampshire Resident:

Thank you for visiting our survey site. The Thayer School of Engineering at Dartmouth is working with the NH Department of Environmental Services and the NH Department of Health and Human Services* to investigate people’s exposure to contaminants in private well water. The information from this survey will help us design effective programs that will protect public health.

To complete the survey, the water entering your home must be supplied by a private well. The person filling out the survey should be an adult, age 18 or over, who is responsible for maintaining your home’s drinking water supply. You may be a renter, homeowner, or landlord (if you look after the drinking water quality for your tenants). Your individual answers will not be shared with anyone and your personally identifiable information will never be used in any presentation or report on this project.

If you complete the survey, you can choose to be entered into a drawing to win an iPad as part of our thanks to you. Please indicate at the end of the questionnaire whether you wish to be entered into this drawing and provide an email address or phone number where you can be reached if you are the winner. (While your chances of winning depend on the number of people who complete the survey and enter the drawing, we estimate the chances to be approximately 1 in 400.)

Your participation in this survey is voluntary. The survey should take approximately 15 minutes to complete. You may choose to stop the survey at any time. The study has been reviewed by the Committee for the Protection of Human Subjects at Dartmouth College. If you have any questions regarding your rights as a participant in this survey, you may contact them by telephone at 603-646-6482.

Questions regarding the survey may be directed to me, Prof. Mark Borsuk, the principal researcher, by telephone at 603-646-9944 or by e-mail at

I hope you enjoy completing the survey, and I look forward to receiving your responses!

Many thanks,

Mark E. Borsuk, Ph.D.
Associate Professor of Engineering

* This survey was supported by the Cooperative Agreement 1U53EH001110-01 from the Centers for Disease Control and Prevention to the New Hampshire Department of Environmental Services (NH DES). The NH DES subsequently entered into an agreement with Dartmouth College (VC #177157B016) to design and implement the survey. The survey’s contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

Question Title

Have you read the description of the study above and do you agree to participate?