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Surveys
2010
October
P
PreparednessATU
PreparednessATU
0%
Exit Survey »
1. Have you ever been a victim of a disaster?
Yes
No
Your age at the time of disaster
2. I believe that disaster preparedness is important for individuals and families?
Strongly Disagree
Disagree
Undecided
Agree
Strongly Agree
How would you rate the disaster risk level of your community?
Low
Medium
High
3. How would you rate your disaster preparedness level?
Poor
Below Average
Average
Good
Excellent
4. Have you had any disaster preparedness training?
First Aid
CPR
CERT
Red Cross
HAZMAT
Fire fighting
Online course
Other
5. Have you ever had an occasion to use your disaster preparedness training?
Yes
No
I do not have any disaster preparedness training.
6. How long could you and your family survive if you could not leave your home and you lost all utilities?
24 hours
36 hours
48 hours
60 hours
72 hours
Other
7. Do you currently have a disaster preparedness kit in your home?
Yes
Somewhat
No
8. What is your primary reason for creating a preparedness kit?
To take care of my family
To help my neighbors
To help my community
I do not have a preparedness kit.
Other
9. Have you ever used your kit for a disaster or accident or incident?
Yes
No
I do not have a kit.
10. Which of the following items are currently included in your disaster preparedness kit and plan?
I do not have a kit.
Water
Food
Medications
Personal hygene items
Copies of important documents
Baby supplies (if applicable)
Pet supplies (if applicable)
Flashlight
Radio
Batteries
Out of state contact person
Back up generator
Back up heat source
First aid kit
Can opener
Whistle
Cash
Sleeping bag or blankets
Extra clothing
Chlorine bleach
Mess kit or disposable items
11. If you do not already have a preparedness kit, how likely are these options to influence you to create one?
Not at all likely
Not very likely
Somewhat likely
Very likely
N/A
Requested by children/family
Advertisement on TV
Information pamplet in the mail
Community or church presentation
Availablility of discounted kits
News story of a nearby disaster
A tax refund on purchased kits
12. What is your gender?
Female
Male
13. Please indicate your age bracket
20-29
30-39
40-49
50-59
60-69
14. Please enter your zip code
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