JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Request Free "NO SMOKING" Signage for Your Business
The Utah Indoor Clean Air Act (UICAA) requires all businesses that allow access by the public to place a "No Smoking" sign at each entrance. Please use the form below to order signage from us.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Sticker- No Smoking Anywhere on Property
How many stickers would you like?
17 x 5 inches
This message works best when smoking is also prohibited outdoors on your property.
You have the right to ban tobacco use anywhere on your property.
(R392-510-4).
Your answer
Cling- No Smoking Inside or within 25 Feet
How many clings would you like?
15 x 4.25 inches
Double-sided cling for inside or outside windows and doors.
A no-smoking sign is required on all entrances or in a position visible upon entry.
(Utah Rule R392-510-12).
Your answer
Any Additional Signage or Materials Requested? We can help you create custom signage for your needs.
Your answer
Contact Name
*
Your answer
Contact Phone Number
*
Your answer
Business Name
*
Your answer
Business/Mailing Address
*
Your answer
Is your business having a smoking violation problem?
Yes
No
Occasionally
Other:
Clear selection
Do you have a tobacco-free policy in place?
Yes
No
Other:
Clear selection
Are you interested in learning about the financial benefits of a tobacco-free workplace?
Yes
No
I would like cessation materials/resources for my employees
Clear selection
For form assistance, please contact us at 435-792-6500 or
ahutchinson@brhd.org
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Bear River Health Department.
Report Abuse
Forms
