Health in the Climate Crisis, Integrative Approaches for Individuals and Communities
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Your Name *
What pronouns do you use? (select all that apply)
Organization (such as a community groups, school, or employer; select all that apply) *
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Which of the following best represents your racial or ethnic heritage? Select all that apply. *
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The following voluntary, anonymous questions are to compare people's reports before and after the conference.  Anonymous information gathered may be shared during the conference or afterwards for educational and planning purposes. Please feel free to add a comment about what other information would be helpful to gather after the conference ends.
How familiar are you with nutrition and other integrated health care approaches to foster resilience to the climate crisis? (scale of 1= ”not familiar”, 9= “very familiar”)
not familiar
very familiar
Clear selection
On a scale of 1-10 how concerned are you about the health impacts of the climate crisis? (1= “not at all” 9= “very concerned”)
not at all
very concerned
Clear selection
How aware are you about ways in which the health of people in marginalized communities is disproportionately affected by the climate crisis? (1= “not aware” 9= “very aware”)
not aware
very aware
Clear selection
How well do you feel you can manage your own mental health care related to the climate crisis? (1= “not well” 9= “very well)
not well
very well
Clear selection
How does NOT acting on the climate crisis impact your health and the health of your community? (1 = “not at all”, 9= “a lot”)
not at all
a lot
Clear selection
A copy of your responses will be emailed to the address you provided.
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