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Public Health
Seattle & King County
401 5th Ave., Suite 1300
Seattle, WA 98104

Click here to email us

Phone: 206-296-4600
TTY Relay: 711
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Home » Tobacco Prevention Program » Second-hand smoke at home
Tobacco Prevention Program
Second-hand smoke at home

Are you experiencing secondhand smoke exposure at home? Or are you a property manager or landlord considering a non-smoking policy? Get started by giving us some information. You can fill out as much as you know, and we will follow up:

Your information:
...
 Name:
Phone:
Email:
Building name:
Street address:
Apt/Unit/Suite:
City:
Zip code:

Are you a landlord or property manager seeking assistance with a non-smoking policy?

Yes No

If you checked Yes, please do not complete the rest of this form.  We will contact you about your policy.

Exposure details:
... Summary of situation:


Where are you exposed to smoke?
Common Areas Inside Unit
Outside Other

If 'Other', please explain:
How is the smoke getting into the unit?

Window or door Shared ventilation
Don't know Other

If 'Other', please explain:
Where is the smoke coming from?
Common areas Outside Other
Inside unit Other unit

If 'Other', please explain:
How many times per week are you being exposed?
<1 1 2 3 4 5 6 7 >7
How is the exposure affecting the enjoyment of your living space?



Resolution details:
...
 What steps have you taken to resolve the problem?
Talked to the person causing the problem
Yes No
Describe the result of this action:

Talked to landlord or property management
Yes No
Describe the result of this action:

Made environmental changes to avoid exposure
Yes No
Describe the result of this action:


Landlord or property manager:
Please supply contact information of your Landlord, Property Manager, or Property Management company.
...
 Name:
Company:
Title:
Street address:
Apt/Unit/Suite:
City:
Zip code:
Phone:
Extension:
Email address:
May we contact your landlord or property manager?
Yes No

Privacy Policy: Public Health does not sell your personal information to 3rd parties nor will you be signed up for any listservs or publications without your permission. Your contact information collected through this webpage is used solely for the purpose of communicating with you regarding the information you submitted above.

Updated: Wednesday, July 30, 2008 at 09:31 AM

All information is general in nature and is not intended to be used as a substitute for appropriate professional advice. For more information please call 206-296-4600 (voice) or TTY Relay: 711. Mailing address: ATTN: Communications Team, Public Health - Seattle & King County, 401 5th Ave., Suite 1300, Seattle, WA 98104 or click here to email us. Because of confidentiality concerns, questions regarding client health issues cannot be responded to by e-mail. Click here for the Notice of Privacy Practices. For more information, contact the Public Health Privacy Office at 206-205-5975.

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