Terry Park CommUNITY
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Terry Park CommUNITY
Home
Charts
About
Top 5 Concerns
Blog
Timeline
Action Items
Cancer Poll
Resources
Contact
Cancer Poll
This poll is for inhabitants and residents of the Terry Park CommUNITY in Huntington Beach, it is for research purposes only and will NOT be shared without permission with any third party.
Cancer Poll for Terry Park CommUNITY
Your Name
E-mail
*
Phone Number
Have you or any of your current household been diagnosed with any type of cancer in the last 25 years?
Yes
No
Yes, but before living in this housing tract
Yes, after we started living here
Have any of your family or friends that lived near the project site been diagnosed with cancer and moved away?
Yes
No
Yes, but is deceased
Specific Cancer Type & Status
Date of Diagnosis
*
Date of Diagnosis
Age Range of Diagnosis
How long living near Terry Park?
Tell us more without HIPPA violations
Send
save@terryparkcommunity.com