Dry eyes or throat?
Yes
No
Wide temperature variances?
Yes
No
Too hot or cold?
Drafts?
Yes
No
Respiratory difficulties?
Yes
No
Fatigue?
Yes
No
Loss of concentration?
Yes
No
Unfamiliar smells or odours?
Yes
No
Headaches?
Yes
No
Coughing?
Yes
No
Dust coming out the air conditioning?
Yes
No
Higher levels of staff illness?
Yes
No
Air vents dirty or discoloured?
Yes
No
Other Comments/Details
Name
Business
Email Address
Telephone
If you would prefer to be contacted by phone
Preferred Response
Email
Telephone