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How many people currently live in your household?Q: 300
Someone in the house has
Asthma, Allergies
Do you have any pets?Q: 405
No answer
Dogs: ; Cats: ; Birds: ; Other:
Do you own or rent your home?Q: 1115
No answer
How did you find out about us?Q: 120
No answer
Zip/Postal Code
North Pole
Climate Temperature
Climate Humidity

General Home Information

What type of home or building do you live in?Q: 400
How many stories is your home?Q: 405
Approximately when was your home built?Q: 410
2010 - 2014
What year was your home built?Q: 411
No answer
How long have you lived in the house?Q: 415
5 - 9 years
Approximately how many square feet is your home?Q: 420
1101 - 1800 sq. ft.
How well maintained is your home inside and outside?Q: 425
Expertly/well maintained (all repairs/routine maintenance are up-to-date)
What type of exterior walls (cladding) does your home have?Q: 435
Is the exterior of your house mostly in the sun or the shade?Q: 445
Mostly in the sun
Please select all of the features that are in your home?Q: 450
Attached or underground garage, Basement (any type), Wall-to-wall carpet (in all or most of the house
What is the age of all/majority of your wall-to-wall carpeting?Q: 470
6 to 15 years old
Describe your crawlspace.
No answer; No answer
Describe your basement – both what it looks like and if it is wet, damp, or dry.Q: 460
No answer; Always is/feels dry
Describe your slab.Q: 464
No answer
Please describe the primary heating system in your home.Q: 475
Where is/are your forced air heating unit(s) located?Q: 485
What type of fuel is used by the heat source?Q: 480
Fuel oil
How often do you use your wood stove/fireplace. (If you have more than one, answer for the one you use most often)Q: 481
No answer
Please describe what kind of fireplace you have and how often you use it. (If you have more than one fireplace, answer for the one you use most often)Q: 465
No answer; No answer
Please describe the primary cooling system in your home.Q: 490
Window air conditioner(s)
Where is your forced air cooling system(s) located?Q: 491
No answer
Do you typically keep one or more windows open?Q: 495
Yes, seasonally


Is your house currently being remodeled or renovated?Q: 502
No answer
Has your home ever had a professionalQ: 500

Energy Retrofit (add insulation and/or air sealing)A: 510.1, A: 510.2, A: 510.3: No answer
Major remodel/renovation (room addition, plumbing/electrical upgrades, kitchen/bath remodelA: 500.1, A: 500.2, A: 500.3: No
Lead remediationA: 515.1, A: 515.2, A: 515.3: No answer
Asbestos abatementA: 520.1, A: 520.2, A: 520.3: No answer
Radon mitigationA: 525.1, A: 525.2, A: 525.3: No answer


Do you live within 1/2 mile of any of the following?Q: 600
No answer
Do you live 1 block from any of the following or can you smell any of the following inside your home?Q: 605


How many meals do you or your family typically cook at home per week?Q: 610
5 to 10
Please tell us a little bit more about your cooking habits.Q: 615

Do you cook with a steamer 5+ times per week?A: 615.1.1, A: 615.1.2: No
Do you boil, simmer, and/or use a wok 5+ times per week?A: 615.2.1, A: 615.2.2: No
Do you cook with gas?A: 615.3.1, A: 615.3.2: No
Do you usually run the range hood while cooking?A: 615.4.1, A: 615.4.2: Yes
Does your range hood blow back into the kitchen?A: 615.5.1, A: 615.5.2: No
How many times a week do you and your family members take showers longer than 10 minutes?Q: 620
6+ times per week
Please tell us a little more about moisture in your home. Do you/your family frequentlyQ: 625

Run the bath fan while showering?A: 625.1.1, A: 625.1.2: No
Use a steam nozzle in your shower?A: 625.3.1, A: 625.3.2: No
Use an indoor jacuzzi or spa tub?A: 625.4.1, A: 625.4.2: Yes
Notice condensation on walls or ceilings?A: 625.5.1, A: 625.5.2: No
Notice condensation in your laundry room?A: 625.6.1, A: 625.6.2: No
Run a humidifier in one or more rooms?A: 625.2.1, A: 625.2.2: No
No leaks
Are any of the following outside your home?Q: 645
Sprinklers that spray water on the outside of the house; Rainwater or snow melt against the sides/near the edge of the house; Down spouts that drain against/near the house;

Indoor Conditions

Do you notice any of the following inside your home?Q: 750

Unpleasant/musty odors or smells: Yes
A lot of dust on surfaces: Yes
Dark/grey dirt or dust on windowsills or near windows: No
Water stains on walls and/or ceilings: No
Visible mold on walls and/or ceilings: No
Even though you don’t see it, do you think you have mold in your house?Q: 770
Does everyone usually take their shoes off when they enter the house?Q: 780
No answer
Does anyone in your home smoke tobacco (or vape) indoors regularly/routinely?Q: 790
No answer
What type of vacuum do you own?Q: 755
Genuine HEPA filtered vacuum
On average how often do you vacuum and/or clean your floors?Q: 760
3x per week or more
Where do you store household/garden chemicals?Q: 765

Cleaning supplies: Inside the house (not in the bedroom)
Personal care supplies: Inside the house (not in the bedroom)
Paint and art supplies: Inside the house (not in the bedroom)
Fertilizers and pesticides: Inside an attached garage, crawlspace, or basement
Are all/most of your cleaning, laundry, and personal care products, “natural” and/or fragrance-free?Q: 791
No answer


Please indicate any pests that you have inside your home (i.e., in attic, crawlspace, wall cavities)?Q: 800
Do you treat for pests indoors or outdoors?Q: 801
No answer
How often do you treat for pests?Q: 805
Indoor: ; Outdoor: Occasionally (1-3x per year)
Do you treat for fleas?Q: 810
No answer
How do you treat for fleas?Q: 815
I treat my pet(s) directly: No answer; I treat my house (bombs): No answer


To what extent do you believe your home is negatively impacting your health or the health of your family?Q: 1000
Do you have any other concerns about your home we should know about?Q: 1015