Clone of Outdoor Lighting Self-Assessment Form

Outdoor Lighting Self-Assessment Form

You will be asked to document the assessment of your outdoor lighting. Your personal information will not be shared with anyone outside of our organization. Required fields are indicated with an asterisk.
Date of Assessment*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Full Name*

First NameLast Name
Email Address*
We will not share your email address with anyone.
Total number of outdoor lights on your home*
More About Shielding

If you can see the bulb from the side, the fixture is not fully-shielded. The shield should completely cover the bulb target light to only where it is needed.

Ceiling-mounted, recessed, or "can lights" and lights completely hidden by eaves do not require shielding. Pathway lights that do not exceed 12 lumens do not need to be shielded. 2-3 watt led bulbs with warm color (2700K) work well for pathways.
Recommended Bulbs

For outdoor home lighting, Dark Sky International recommends 450 lumens in brightness and 2700K in temperature. Bulbs should not be brighter than 800 lumens and 3000K.
Outdoor Fixtures (add as many as necessary)*
What can we do to help? How can we improve? Any additional questions or comments?
Please verify that you are human*
Should be Empty: