Part 1: Healthy Cleveland Choose Water First for Thirst Pledges
Please note this is an individual pledge, not for an organization.
I pledge to drink tap water first for my thirst over bottled water and sugary beverages. I also pledge to eliminate or reduce the use of disposable plastic water bottles by using reusable drinkware and water bottles, whenever possible. *
(Please type name in box below)
Your answer
Part 2: Healthy Cleveland Water Consumption Survey
Please help us understand your current consumption of water by responding to this quick survey.
1) How often do you choose water over sugary beverages (such as juice or pop) for your thirst? *
Required
2) How many 8 oz. glasses of water on an average day do you currently drink? *
Required
3) How many sugary beverages (such as juice or pop) a day do you currently drink? *
Required
4) How often do you drink water from a disposable plastic water bottle? *
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service