Health Hazard Survey

What is your primary source of drinking water?

• • Tap water

• • Filtered tap water

• • Bottled water

• • Well water

Tags

NGSS.MS-ESS2-4

How would you rate the air quality in your neighborhood?

• • Excellent

• • Good

• • Fair

• • Poor

Tags

NGSS.MS-ESS2-5

NGSS.MS-ESS2-6

Do you live near any of the following? (Select all that apply)

• • Major highway

• • Factory or industrial plant

• • Landfill

• • Power plant

• • None of the above

Tags

NGSS.MS-ESS3-3

NGSS.MS-ESS3-4

Does anyone in your life smoke indoors (or just close to you)?

• • Yes

• • No

• Have you noticed mold or mildew in the places you frequent? (home, school, etc.)

• Yes

• No

How often do you use chemical-based cleaning products?

• • Daily

• • Weekly

• • Rarely

• • Never

Tags

NGSS.MS-PS1-2

NGSS.MS-PS1-3

How often do you consume locally grown produce?

• • Often

• • Sometimes

• • Rarely

• • Never

Tags

NGSS.MS-LS2-5

Do you or your family use pesticides or herbicides in your garden or lawn?

• • Yes

• • No

Tags

NGSS.MS-ESS3-3

NGSS.MS-LS2-5

NGSS.MS-LS2-4

How do you typically commute to school?

• • Car

• • Bus

• • Bicycle

• • Walking

Are there parks or green spaces near your home?

• • Yes

• No