Impact of Heat Wave Survey
Help us understand how recent heat waves have affected you and your community.
Full Name
First Name
Last Name
Age
*
Location (City/Town and Country)
*
How have the recent heat waves affected you personally?
*
Health issues (e.g., dehydration, heat exhaustion)
Disrupted daily routine/work/school
Increased energy bills/cooling costs
Difficulty sleeping
No significant impact
Other
How severe has the impact of the heat wave been for you?
*
Not severe
1
2
3
4
Very severe
5
1 is Not severe, 5 is Very severe
What steps have you taken to cope with the heat wave? (Select all that apply)
*
Staying indoors during peak heat
Using fans/air conditioning
Increasing water intake
Visiting public cooling centers
Changing work/school schedule
No special actions taken
Other
Please share any additional comments or suggestions regarding heat wave impacts or community needs.
Submit Survey
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