Form
Approved OMB
No. 0923-0056 Exp.
Date 07/31/2020
Date
Dear
Click
here to enter text.,
We greatly appreciate your participation in the Milwaukee Angler Study. As part of your participation you completed a detailed questionnaire. We have some additional questions that we would like to ask of you. The enclosed questionnaire contains seven new questions asking about fish that you caught from water bodies in Milwaukee and the surrounding southeastern area of Wisconsin. We know your time is very valuable - completion of this questionnaire should take approximately 5 minutes. You can return the completed questionnaire in the enclosed, self-addressed envelope.
Thank you for your time. If you have questions please email dhsfishstudy@dhs.wisconsin.gov or contact Brooke Thompson at 608-261-9325.
Sincerely,
Program Manager, Wisconsin Department of Health Services
ATSDR estimates the average public reporting burden for this collection of information as 5 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0923-17IY).
FISH EATEN IN THE LAST 12 MONTHS
These fish are sometimes called ‘sport-caught fish’ or ‘sportfish’. We will be asking you to estimate how many fish meals you have eaten in the last 12 months.
Questions 1-3 ask about fish caught in different lakes, rivers, and streams in Milwaukee and the surrounding southeastern area of Wisconsin. Please refer to Image 1 at the back of this questionnaire which shows the lakes, rivers, and streams we are interested in.
In the last 12 months, have you eaten any fish caught by you or someone you know from the lakes, rivers, and streams in southeastern Wisconsin, shown in Image 1? Please think about these locations only.
__________ total number of meals in the last 12 months
Don’t know
Prefer not to answer
Thinking about fish caught in any of the lakes, rivers, and streams in Milwaukee and the surrounding southeastern area of Wisconsin, shown in Image 1, how has the total amount of fish you eat changed during the past five years?
Eat less
Same or about the same
Eat more
Don’t know
Prefer not to answer
The following questions are about types of fish you have eaten that were caught by you or someone you know. When answering these questions, please think only about fish caught in the lakes, rivers, and streams in Milwaukee and the surrounding southeastern area of Wisconsin, shown in Image 1.
In the last 12 months, have you eaten: |
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Yes |
No |
Don’t know |
Prefer not to answer |
If YES, approximately how many times did you eat it in the last 12 months? |
Black crappie |
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Number: ______ Don’t know how many |
Bluegill |
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Number: ______ Don’t know how many |
Bullhead |
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Number: ______ Don’t know how many |
Buffalo |
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Number: ______ Don’t know how many |
Carp |
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Number: ______ Don’t know how many |
Channel catfish |
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Number: ______ Don’t know how many |
Chubs |
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Number: ______ Don’t know how many |
Salmon (chinook or coho) |
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Number: ______ Don’t know how many |
Lake whitefish |
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Number: ______ Don’t know how many |
Muskellunge (Muskie) |
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Number: ______ Don’t know how many |
Northern pike |
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Number: ______ Don’t know how many |
Redhorse |
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Number: ______ Don’t know how many |
Rockbass |
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Number: ______ Don’t know how many |
Largemouth bass |
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Number: ______ Don’t know how many |
Smallmouth bass |
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Number: ______ Don’t know how many |
White bass |
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Number: ______ Don’t know how many |
Sheepshead |
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Number: ______ Don’t know how many |
Smelt |
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Number: ______ Don’t know how many |
Walleye |
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Number: ______ Don’t know how many |
White sucker |
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Number: ______ Don’t know how many |
Yellow perch |
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Number: ______ Don’t know how many |
White perch |
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Number: ______ Don’t know how many |
Brown trout |
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Number: ______ Don’t know how many |
Lake trout |
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Number: ______ Don’t know how many |
Rainbow trout |
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Number: ______ Don’t know how many |
Other fish types (please specify): |
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Number: ______ Don’t know how many |
Other fish types (please specify): |
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Number: ______ Don’t know how many |
Other fish types (please specify): |
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Number: ______ Don’t know how many |
Questions
4-7 ask about fish caught specific lakes, rivers, and streams in
southeastern Wisconsin. Each question is about a different area and
will ask you to look at Images 2, 3, 4, or 5, at the back of this
questionnaire.
In
the last 12 months, have you eaten any fish caught in the lakes,
rivers, and streams near the Milwaukee
area,
highlighted in Image 2?
Yes
No
Don’t know
Prefer not to answer
In
the last 12 months, have you eaten any fish caught in the lakes,
rivers, and streams near the Fond
du Lac and Oshkosh areas,
highlighted in Image 3?
Yes
No
Don’t know
Prefer not to answer
In
the last 12 months, have you eaten any fish caught in the lakes,
rivers, and streams near the Sheboygan
and Manitowoc areas,
highlighted in Image 4?
Yes
No
Don’t know
Prefer not to answer
In
the last 12 months, have you eaten any fish caught in the lakes,
rivers and streams near the Beaver
Dam, West Bend, Waukesha, and Jefferson areas,
highlighted in Image 5?
Yes
No
Don’t know
Prefer not to answer
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | SLN |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |