"Akwesasne Family Guide to Eating Locally-Caught Fish" Survey

If you did not get a copy and read it, please go to www.srmtenv.org and read the guide before completing this survey.
Complete this survey by June 20, 2014 and receive a FREE GIFT! (must provide name and mailing address at end of survey) If you have already completed a paper survey, thank you for your response! You do not need to complete this electronic version.

Niawenko:wa!

	Yes	No	Not Sure
1. Will the fish guide change the amount of fish that you eat from Akwesasne waters?	1. Will the fish guide change the amount of fish that you eat from Akwesasne waters? Yes	1. Will the fish guide change the amount of fish that you eat from Akwesasne waters? No	1. Will the fish guide change the amount of fish that you eat from Akwesasne waters? Not Sure
2. Will the fish guide change where you catch the fish that you eat?	2. Will the fish guide change where you catch the fish that you eat? Yes	2. Will the fish guide change where you catch the fish that you eat? No	2. Will the fish guide change where you catch the fish that you eat? Not Sure
3. Will the fish guide change the way you clean your fish?	3. Will the fish guide change the way you clean your fish? Yes	3. Will the fish guide change the way you clean your fish? No	3. Will the fish guide change the way you clean your fish? Not Sure
4. Will the fish guide change the way you cook fish?	4. Will the fish guide change the way you cook fish? Yes	4. Will the fish guide change the way you cook fish? No	4. Will the fish guide change the way you cook fish? Not Sure
5. Will the fish guide change the types of fish you eat?	5. Will the fish guide change the types of fish you eat? Yes	5. Will the fish guide change the types of fish you eat? No	5. Will the fish guide change the types of fish you eat? Not Sure
6. Do you trust the information in the new fish guide?	6. Do you trust the information in the new fish guide? Yes	6. Do you trust the information in the new fish guide? No	6. Do you trust the information in the new fish guide? Not Sure

Yes

Not Sure

1. Will the fish guide change the amount of fish that you eat from Akwesasne waters?

1. Will the fish guide change the amount of fish that you eat from Akwesasne waters? Yes

1. Will the fish guide change the amount of fish that you eat from Akwesasne waters? No

1. Will the fish guide change the amount of fish that you eat from Akwesasne waters? Not Sure

2. Will the fish guide change where you catch the fish that you eat?

2. Will the fish guide change where you catch the fish that you eat? Yes

2. Will the fish guide change where you catch the fish that you eat? No

2. Will the fish guide change where you catch the fish that you eat? Not Sure

3. Will the fish guide change the way you clean your fish?

3. Will the fish guide change the way you clean your fish? Yes

3. Will the fish guide change the way you clean your fish? No

3. Will the fish guide change the way you clean your fish? Not Sure

4. Will the fish guide change the way you cook fish?

4. Will the fish guide change the way you cook fish? Yes

4. Will the fish guide change the way you cook fish? No

4. Will the fish guide change the way you cook fish? Not Sure

5. Will the fish guide change the types of fish you eat?

5. Will the fish guide change the types of fish you eat? Yes

5. Will the fish guide change the types of fish you eat? No

5. Will the fish guide change the types of fish you eat? Not Sure

6. Do you trust the information in the new fish guide?

6. Do you trust the information in the new fish guide? Yes

6. Do you trust the information in the new fish guide? No

6. Do you trust the information in the new fish guide? Not Sure

	True	False	Not Sure
7. The advice is for the entire family - pregnant women, children - all ages.	7. The advice is for the entire family - pregnant women, children - all ages. True	7. The advice is for the entire family - pregnant women, children - all ages. False	7. The advice is for the entire family - pregnant women, children - all ages. Not Sure
8. A portion of cooked fish is about the size of my palm.	8. A portion of cooked fish is about the size of my palm. True	8. A portion of cooked fish is about the size of my palm. False	8. A portion of cooked fish is about the size of my palm. Not Sure
9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains.	9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains. True	9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains. False	9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains. Not Sure
10. Bottom feeders are the most contaminated of the fish species.	10. Bottom feeders are the most contaminated of the fish species. True	10. Bottom feeders are the most contaminated of the fish species. False	10. Bottom feeders are the most contaminated of the fish species. Not Sure
11. I could eat more than one (1) portion of fish in the same meal.	11. I could eat more than one (1) portion of fish in the same meal. True	11. I could eat more than one (1) portion of fish in the same meal. False	11. I could eat more than one (1) portion of fish in the same meal. Not Sure
12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal.	12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal. True	12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal. False	12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal. Not Sure
13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes.	13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes. True	13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes. False	13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes. Not Sure
14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish.	14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish. True	14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish. False	14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish. Not Sure

True

False

Not Sure

7. The advice is for the entire family - pregnant women, children - all ages.

7. The advice is for the entire family - pregnant women, children - all ages. True

7. The advice is for the entire family - pregnant women, children - all ages. False

7. The advice is for the entire family - pregnant women, children - all ages. Not Sure

8. A portion of cooked fish is about the size of my palm.

8. A portion of cooked fish is about the size of my palm. True

8. A portion of cooked fish is about the size of my palm. False

8. A portion of cooked fish is about the size of my palm. Not Sure

9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains.

9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains. True

9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains. False

9. Removing the skin, fat and internal organs from fish will not help to reduce the amount of polychlorinated biphenyls (PCBs) it contains. Not Sure

10. Bottom feeders are the most contaminated of the fish species.

10. Bottom feeders are the most contaminated of the fish species. True

10. Bottom feeders are the most contaminated of the fish species. False

10. Bottom feeders are the most contaminated of the fish species. Not Sure

11. I could eat more than one (1) portion of fish in the same meal.

11. I could eat more than one (1) portion of fish in the same meal. True

11. I could eat more than one (1) portion of fish in the same meal. False

11. I could eat more than one (1) portion of fish in the same meal. Not Sure

12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal.

12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal. True

12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal. False

12. It is best to space out my portions of fish over a month instead of eating all of them in a single meal. Not Sure

13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes.

13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes. True

13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes. False

13. You can tell if a fish is contaminated with chemicals by how it looks smells or tastes. Not Sure

14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish.

14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish. True

14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish. False

14. Grilling, baking or broiling fish so the fat drips off while cooking will not reduce the amount of PCBs in the fish. Not Sure

"Akwesasne Family Guide to Eating Locally-Caught Fish" Survey

Did you get a copy of the "Akwesasne Family Guide to Eating Locally-Caught Fish"??

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* 1. Questions 1 - 6: Click in one of the circles (Yes, No, or Not Sure) to answer each question.

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* 2. Questions 7 - 14: Click in one of the circles next to each sentence to answer whether you feel the statement is True, False, or Not Sure.

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* 3. What other ways can we get the “Akwesasne Family Guide to Eating Locally-Caught Fish” out to the community?

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* 4. What is today's date?

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* 5. Are you (check one)

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* 6. What is your Postal/Zip Code?

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* 7. What is your age?

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* 8. Enter your name and address so we can mail you your FREE GIFT!

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* 9. Enter any comments you would like to make about the “Akwesasne Family Guide to Eating Locally-Caught Fish”?

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If you have any questions, please call Mary La France, Saint Regis Mohawk Tribe Environment Division (518) 358-5937. Niawenko:wa!