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Fracking impact survey
Three questions in response to "Fractured: The personal cost of fracking"
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How have you been affected by fracking?
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Have you sought help for your concerns?
Yes
No
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What else would you like to know about this issue?
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Name
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Email (for Fractured followup)
Your answer
Phone (for Fractured followup)
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ZIP (or Postal) Code
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