For individuals Information collected in this form is private. Your personal details such as your name are not required in this form. How would you describe your workspace or area *Too hotToo coldToo humidToo dryJust okHow many hours do you spend in your workspace *Do you sometimes complain about headaches, tiredness, nausea, sinus trouble, itchy throat or skin, congestion? *YesNoNot sureDo your symptoms diminish or go away when you leave work? *YesNoNot sureWhen does cleaning usually take place? *Before working hoursDuring working hoursAfter working hoursWhat do you think is the most likely cause for poor IAQ in your area? *Do you suffer from any chronic illness? *YesNoRather not say* Illness details not requiredDoes your organisation use any Indoor Air Quality Monitoring system? *YesNoNot sureDo you believe Indoor Air Quality Monitoring could benefit you and other fellow employees? *YesNoI need to more information about itCompany name *SubmitPlease do not fill in this field.
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