Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Opinions on water resources
With skepticism on our water resources, there are rising concerns on the quality and safety of the water we use for everyday life. Please fill out this survey so that we can get more information on the subject.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Do you feel safe letting children, pets, or yourself swim in local natural water sources?
*
Yes
No
What fertilizers, pesticides, or lawn care chemicals does your household use?
Fertilizer
Weed killer
none
Other:
Clear selection
Have you or your family ever experienced health concerns that you think might be related to water quality?
*
Yes
No
How much do you trust local officials or water providers to keep you informed about water safety? scale 1-5
*
1
2
3
4
5
Have you noticed changes in local water (taste, smell, appearance) over the past few years?
*
Definitely
Maybe
No
How do you think water pollution could be handled?(This is not required.)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Gwinnett County Public Schools.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report