Employee Health and Smoking Screener (Fire Fighter Version)
This page contains 33 questions. To record your answers, you must click "Submit" button at end of page 2.
This survey was developed to determine information on smoking status and is voluntary. Do not write your name on this survey. The information you provide will be collected and analyzed by a third party that will not be able to determine your individual identity. Your privacy is completely protected. The results will be reported for the entire PA Fire Fighters Association in total; no individual results will be reported. You are providing your permission for third party analysis by completing this form. The data will be used to support further health education to Fire Fighters.