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White Ribbon Radon Testing Program - End of test data
Detector Serial Number
*
Second Detector Serial Number
If you received a duplicate test.
Email
*
example@example.com
Confirm E-mail
*
example@example.com
Postal Code of the building tested
*
Test End Date (day detector was returned to the collection box)
*
/
Day
/
Month
Year
Where did you place the radon detector?
*
Basement
First/Ground Floor
Second Floor
Bi-level
In what room did you place the radon detector?
Bedroom
Living Room
Other Living Area
Non-living area
Please Specify
Would you help us by answering a few additional questions about the conditions in your home during the test period?
Yes
No
During the testing period, how often were the windows open in the room being tested?
Never or almost never (1 - 5 days)
Once in a while (5 - 15 days)
Frequently (30 - 60 days)
Often (61+ days)
During the testing period, how often were windows open in other areas of the house?
Never or almost never (1 - 5 days)
Once in a while (5 - 15 days)
Frequently (30 - 60 days)
Often (61+ days)
During the testing period, did you use the kitchen fan while cooking?
Always
Sometimes
Never
N/A
Does someone in the household smoke?
Yes
No
Yes, but only outside
Previous smoker, no longer smokes
Would you be interested in being contacted in future for a follow-up survey?
Yes
No
Submit
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