Harris County Pollution Control is conducting research on your concern for pollution in your community. The survey should take approximately 20 minutes. You can only take the survey once. Questions marked with an asterisk (*) are required. If you have any questions about the survey, please email us: PCS-Communications@pcs.hctx.net
Please provide your legal (first and last) name. If unwilling, please write N/A.
What is your current home address? If unwilling, please write N/A.
If unwilling to provide your address, please write your zip code. If you have provided your home address, please write N/A.
How long have you lived at your current address?
Less than 1 year
1 to 5 years
6 to 10 years
More than 10 years
Are you concerned about any of the following environmental issues in your community?
Hazardous waste pollution
None of the above
Have you or someone in your household been diagnosed with any of the following illness?
No one in my household has been diagnosed with an illness
Please select any health condition that you or a member of your household have experienced without reasonable cause.
Irritation of eyes and nose
Do you have any familiarity with Harris County Pollution Control Services Department (PCS)?
Are you aware that you can make any complaint related to potential harmful exposures to chemical pollutants, in your area, to the PCS?
Letter of Consent
Should be Empty: