Screening Survey

1.) How would you rate your overall experience with the library loan out radon program?

2.) How did you hear about the library radon detector screening program?

If your answered "e.) Other" above, please specify:

3.) Why did you decide to conduct a radon screening in your home?

If your answered "d.) Other" above, please specify:

4.) Did you talk about radon with friends/family?

5.) On which level was the device placed?

If your answered "d.) Other" above, please specify:

6.) In which room was the radon detector placed?

If your answered "d.) Other" above, please specify:

7.) Why type of residence do you live in?

If your answered "e.) Other" above, please specify:

8.) When was your residence built?

9.) Does anyone in your residence smoke?

10.) What was your long term screening as shown on the device (Bq/m3)?

Approximately how many weeks did you test?

11.) Did you look elsewhere for more information regarding radon?

Skip this if your answered No to the above: And if so where:

12.) Do you plan on following up with a long-term radon test after your return the digital detector to the library?

13.) If after a long term test your levels are above 200 Bq/m3 will you take action to reduce in your home?

Please explain your decision

14.) What do you identify as:

15.) Age:

16.) Additional Comments (problems, clarity of instructions, etc.):

17.) First 3 digitals of Postal Code?

18.) Would you like Alberta Lung to contact you for more follow-up regarding Radon? If so please provided your email below.