Sanitary Improvement Districts (SID) Outdoor Recreation Facilities Survey
RequiredRequired Question(s)
1.
Please tell us about you.

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com

Required 2.

Which city is your SID park in?

Bellevue
Gretna
LaVista
Papillion
Springfield
Other  
3.

What housing development is it in?

 

350 characters left.
Required 4.
Does your park have a tobacco policy?
If your park doesn't have a smoke-free policy, please skip to question #8.
No
Yes
5.

If your park has a tobacco policy, which of the following best describes it?

Ban on all tobacco use (including smokeless tobacco)
Ban on smoking
Smoking restricted to certain areas
6.

Are electronic nicotine delivery systems (eg. e-cigarette type devices) included in your policy?

No
Yes
7.

If your park has a tobacco-free/smoke-free policy, how is it visibly communicated?

 

Please check all that apply

Entrance sign
Fence mounted sign
Stand-alone sign
Other  
8.

Would you like to be included on our free publicized list to promote smoke-free recreation options in Sarpy County?

No
Yes
Required 9.

What are the benefits of having a tobacco-free/smoke-free policy?

 

Please check all that apply. 

Eliminating tobacco litter
Establishing better role models for youth
Promoting community well-being
Reducing youth opportunity to tobacco
Unsure
Other  
Required 10.

What are the biggest obstacles to implementing a tobacco-free/smoke-free policy?

 

Please check all that apply.

Concern of legality of policy
Complaints from users of the ORF
Enforcement
Objections of SID board members or residents
Unsure
Other  
Required 11.

Would you like to be contacted with free information on how to implement a tobacco-free/smoke-free policy? 

No
Yes
Required 12.

Would you like to be added to our email list for quarterly updates?

No
Yes