To download blank versions of the 2012 ShakeOut Survey, select your category from the list below.

NOTE: The Survey has 4 participation types, each with multiple sections. The files linked to below are blank surveys for each type, excerpted from the entire survey. Because many questions are skipped based upon participant responses, the question numbers will not match those in the online survey though they are in the same order.

Select the appropriate survey based on how you responded online:

Yourself and your household

An organization (including businesses, healthcare, community groups, childcare, faith-based groups, and all others)

A K-12 Education Institution (Schools, districts, homeschools, etc.)

A higher education institution (universities, colleges, trade/vocational schools, etc.)