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Do you know what sick building syndrome is?
 
Yes
 
No
 
 
 
If yes please explain:
   
 
 
 
Have you/your employees/tenants ever complained about any of the following symptoms?
 
Headache
 
Eye irritation
 
Fatigue
 
Sore throat
 
Drowsiness
 
Nausea

 
 
 
Do you believe any of these symptoms could be from the air quality in the building?
 
Yes
 
No
 
 
 
Is your building located next to or near any of the following:
 
Parking lot
 
Loading docks
 
Cooling towers
 
Other:________________________

 
 
 
Is your office space small with lots of computers/office equipment?
 
Yes
 
No
 
 
 
Have you/your employer/buildingowner ever had the HVAC system in your building cleaned(that you are aware of)?
 
Yes
 
No
 
 
 
Did you know keeping your HVAC system cleaned and well maintained could save you money?
 
Yes
 
No
 
 
 
Did you know a poor designed HVAC system could cause contamination to the environment?
 
Yes
 
No
 
 
 
Did you know that cleaning and maintaining your HVAC system on a regular basis is one of the easiest, most cost effective, green things you can do for your company?
 
Yes
 
No
 
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