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.
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.
3. Is there anything else you want to tell us about your proximity to fracking processes?
Your answer
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?
Your answer
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?
Your answer
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?
Your answer
7. Has your property value been effected by fracking?
Is there anything else you would like to tell us about this?
Your answer
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?
Your answer
9. Other than reaching out to governmental agencies or representatives, what else have you been doing in your community to deal with this situation?
Your answer
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?
Your answer
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?
Your answer
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?
Your answer
WHAT YOU NEED
13. What trainings would you most like to see offered in your community?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
Your answer
14. What resources besides money would be helpful in your community?
CHECK ALL THAT APPLY
Is there anything else you would like to tell us about this?
Your answer
15. Is there anything else you would like to tell us about anything?
Your answer
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?
Your answer
17. What is your e-mail address?
Your answer
18. What is your phone number?
Your answer
19. What is your zip code?
Your answer
20. What is your race?
CHECK ALL THAT APPLY
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