Newtown Health District - Online Tick Survey Question Title * 1. Are you a resident of Newtown, CT ? a. Yes b. No Question Title * 2. How long have you been a resident of Newtown, CT ? a. Less than one year b. One to five years c. More than 5 years up to ten years d. more than ten years Question Title * 3. What is your age range ? a. Under 25 b. 25 to 40 c. 41 to 60 d. 61 to 80 e. Over 80 Question Title * 4. Are there children under the age of 18 living in your home ? a. Yes, under 12 years of age only b. Yes, 12-18 years of age only c. Children in both age ranges d. No Question Title * 5. As far as you know, have you ever been bitten by a deer tick ? a. Yes b. No Question Title * 6. Have you ever gone to the doctor and received medication for a deer tick bite ? a. Yes b. No c. Unsure Question Title * 7. How many times have you gone to the doctor and received medication for a deer tick bite ? a. Once b. More than once c. Never Question Title * 8. Do you use tick repellents ( spray on clothes and/or skin)? a. Yes, all the time b. Yes, some of the time c. Never Question Title * 9. When you have been outside, do you wear protective clothing such as long pants, long sleeved shirts and socks and shoes to protect yourself from tick bites ? a. Yes, all the time b. Yes, some of the time c. Never Question Title * 10. When you have been outside, do you shower within 2 hours/ shortly after coming indoors to protect yourself from tick bites ? a. Yes all the time b. Yes, some of the time c. Never Question Title * 11. Do you do a daily tick check of your body to make sure there are no ticks on you ? a. Yes, all the time b. Yes, some of the time c. Never Question Title * 12. Have you ever gone to the Newtown Health District website for information about tick-borne disease prevention ? a. Yes b. No ( If no skip to question 14) c. I don't know 33% of survey complete. Next