Purpose of This Survey
This tracker is designed for individuals and families living in areas affected by potential chemical exposure. It allows residents to document symptoms, medical conditions, or diagnoses that may have developed or worsened following a known environmental contamination or chemical release. By collecting this information, we aim to identify community health trends, improve public awareness, and support collective advocacy for medical and environmental action.
Why We’re Collecting This Data
Communities exposed to environmental contaminants often experience ongoing or unexplained health issues long after the initial event. Unfortunately, there is rarely a coordinated effort to track or analyze these patterns. This tracker helps:
Empower residents to document and share their health experiences
Detect trends or clusters of illness in affected areas
Strengthen the community’s case for medical resources, environmental testing, and policy response
Support researchers, healthcare providers, and legal advocates seeking data-driven insight
How Your Data Will Be Used
Your responses may be used to:
Track and map common symptoms or diagnoses over time Identify geographic or demographic patterns of illness
Develop community health reports for public awareness and advocacy
Support requests for medical care, environmental studies, or cleanup actions (With consent)
Share anonymized data with researchers, journalists, or legal representatives investigating community health impacts
Your privacy matters
Your information will never be sold, shared, or used for profit. All data will be stored securely and used only for community health and advocacy purposes. This survey is not a substitute for professional medical care. Please contact a healthcare provider if you are experiencing serious or worsening symptoms. By submitting, you agree that your information may be used anonymously for research and reporting purposes. If you prefer complete anonymity, you may email your report directly to: grg-ep@health.ucsd.edu
Submitting Your Information
You can submit this form: Anytime you experience new or worsening symptoms Multiple times if your health changes over time Each submission helps build a clearer picture of community health impacts.