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1. Are you ever achy all over?

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2. Do you feel worse when you enter certain buildings (home, office, school)?

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3. Do you have a blocked, runny, or stuffy nose, and/or experience nosebleeds?

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4. Do you have a cough, headaches, or nausea when exposed to various chemicals?

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5. Do you have difficulty recalling the names of people/things you know or have trouble

taking in new information?

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6. Do you have difficulty sleeping? Or do you wake up during the night with shortness of breath and/or a coughing attack?

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7. Do you have shortness of breath when you’re not doing anything strenuous?

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8. Do your symptoms decrease when spending time in a different location for at least a few days?

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9. Have you ever experienced water damage at home, school, or work?
Are there any wet spots in your home (current or past) or is your basement ever wet?

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10. Have you seen mold growing at home, school, or work? Do any of these places have a damp or mildewy odor?

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