STFA's National Fracking Needs Assessment Survey

In an effort to serve impacted communities, the Stop the Frack Attack Network (STFA) is asking that you fill out this survey. STFA is committed to identifying community need and this survey will help us determine a course of action. The survey will be confidential with folks privacy to be protected. Please fill out the survey and share with impacted community members in your networks. Tell us what you need, we want to support you!
1. What part of the fracking process are you impacted by?
If you live in proximity to multiple pieces of the fracking process listed below, please selected the one closest to you. Below you can describe in greater detail everything in your area.
Clear selection
2. How close do you live to the piece of the fracking process you identified above?
If you marked "I am not impacted yet, but I am likely to be soon," please skip this question.
Clear selection
3. Is there anything else you want to tell us about your proximity to fracking processes?
The IMPACT of FRACKING
In this section, answer to the best of your ability. You don't have to be a scientist to know what's happening to your air and water so let us know!
4. Has your water been effected by fracking? If so, in what ways?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
5. Has your air been effected by fracking? If so, in what ways?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
6. Has you or a member of your household’s health been effected by fracking? If so, in what ways?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
7. Has your property value been effected by fracking?
Clear selection
Is there anything else you would like to tell us about this?
WHAT YOU HAVE AND WHAT YOU'VE DONE
8. Have you reached out to any government organizations about the situation in your community?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
9. Other than reaching out to governmental agencies or representatives, what else have you been doing in your community to deal with this situation?
10. Which of the following resources have you accessed or do you have access to?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
11. Have groups from outside your community engaged with you?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
12. Were there any challenges that arose from groups from outside your area engaging with you or your community?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
WHAT YOU NEED
13. What trainings would you most like to see offered in your community?
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Is there anything else you would like to tell us about this?
14. What resources besides money would be helpful in your community?
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Is there anything else you would like to tell us about this?
15. Is there anything else you would like to tell us about anything?
DEMOGRAPHICS
We will use this section to follow up with folks to get further involved in the work that comes out of this survey. Your information will not be shared with anyone but the organizers within the Stop the Frack Attack Network working on this project. Feel free to leave any question blank.
16. What is your name?
17. What is your e-mail address?
18. What is your phone number?
19. What is your zip code?
20. What is your race?
CHECK ALL THAT APPLY
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