Consent

 

Question Title

* 1. As you may know, the Millville EA is working with the New Jersey Work Environment Council (https://njwec.org/) about the indoor air quality (IAQ) issues reported in your building,
As part of this effort, we need to know more about the symptoms you and others in your building may have. This questionnaire is designed to do that. (Since a variety of factors can influence symptoms, there are some personal health and occupational stress questions.) To be sure we know about the hazards in your building, please click on the name of your building when you start the survey.

All personal information collected is confidential. We will put the results into group report so that individual responses won't be recognized.

Please answer the questions by December 14, 2018. If you have questions about the survey, please send an e-mail to Tina Hulitt at kristina.hulitt@millvillen.gov or Tony Cappello at acappello@njea.org.

Participating in this survey means that you consent to your confidential responses being used in group reports, academic research and publications. Please indicate your agreement below.

I accept these conditions and consent to continue this survey:

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