Informed Consent: The purpose of this survey is to better understand the unique environmental health impacts and priorities of residents of the Gold Country. This survey contributes to research being conducted by local non-profit The Sierra Fund as part of our Environmentally Healthy Communities Program. This survey is voluntary. Completing the online survey will take approximately 20 minutes. Your response will be confidential, and we do not collect identifying information such as your name, email address, or IP address.

There are no foreseeable risks associated with this survey. There may be public health benefits associated with this survey by helping to identify unique exposure pathways and community health priorities. If you have questions about this survey or associated research please contact Alex Keeble-Toll, M.A., M.Sc., alex.keeble-toll@sierrafund.org.

Clicking on the “Next” button below indicates that:

• You have read the above information.

• You voluntarily agree to complete the survey.

Thank You.

1 = most concerned about, 4 = least concerned about, use each value only once

1 = most concerned about, 4 = least concerned about, use each value only once

1 = most concerned about, 4 = least concerned about, use each value only once