This free survey is powered by
Create a Survey
Surveys
2014
May
H
Healthy Office Survey
Healthy Office Survey
0%
Exit Survey
Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
I Agree
*
Where are you located in the building, e.g. room number, area, section, wing, etc.
*
On which floor of the building do you work? (indicate which is most appropriate)
-- Select --
Below Ground
Ground Level
1st floor
2nd floor
3rd floor
4th floor
5th floor
6th floor
7th floor
8th floor
9th floor
10th floor
11th floor
12th floor
13th floor
14th floor
15th floor
16th floor
17th floor
18th floor
19th floor
20th floor
21st floor
22nd floor
23rd floor
24th floor
25th floor
26th floor
27th floor
28th floor
29th floor
30th floor
31st floor
32nd floor
33rd floor
34th floor
35th floor
36th floor
37th floor
38th floor
39th floor
40th floor
41st floor
42nd floor
43rd floor
44th floor
45th floor
46th floor
47th floor
48th floor
49th floor
50th floor
51st floor
52nd floor
53rd floor
54th floor
55th floor
56th floor
57th floor
58th floor
59th floor
60th floor
61st floor
62nd floor
63rd floor
64th floor
65th floor
66th floor
67th floor
68th floor
69th floor
70th floor
71st floor
72nd floor
73rd floor
74th floor
75th floor
76th floor
77th floor
78th floor
79th floor
80th floor
81st floor
82nd floor
83rd floor
84th floor
85th floor
86th floor
87th floor
88th floor
89th floor
90th floor
91st floor
92nd floor
93rd floor
94th floor
95th floor
96th floor
97th floor
98th floor
99th floor
100th floor
*
Approximately which direction(s) do the windows in your office face? (Mark all that apply)
North
North-east
East
South-east
South
South-west
West
North-west
Personal Well-being
You do not need to report the frequency of each symptom unless it is better on days away from the office.
*
In the past 12 months have you had more than
two
episodes of:
Itchy or Watery eyes
Yes
No
If 'Yes', was this better on days away from the office?
*
In the past 12 months have you had more than
two
episodes of:
Dryness of the eyes
Yes
No
If 'Yes', was this better on days away from the office?
*
In the past 12 months have you had more than
two
episodes of:
Blocked or stuffy nose
Yes
No
If 'Yes', was this better on days away from the office?
*
In the past 12 months have you had more than
two
episodes of:
Runny nose
Yes
No
If 'Yes', was this better on days away from the office?
*
In the past 12 months have you had more than
two
episodes of:
Dry throat
Yes
No
If 'Yes', was this better on days away from the office?
Healthy Air Solutions (Pty) Ltd.
Loading...
close
Loading...
Close
qprun1.questionpro.net
Loading...
