Multi-Family Housing Tobacco Policy Survey

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Multi-Family Housing Tobacco Policy Survey

To learn more about smoke-free housing visit TEAMTobaccoFree.org

Email *

Date *

YYYY

Name *

Complex Name *

Complex Address *

Phone Number *

How many multi-unit housing buildings are on your property? *

How many units are in your complex? *

Who owns your complex? *

Who manages your complex? *

Does your complex have a tobacco policy? *

Yes

If your complex has a tobacco policy, which of the following best describes it?

All of the buildings are required to be 100% smoke-free

All of the buildings are required to be 100% smoke & vape-free

Some of the buildings are required to be 100% smoke free

Some of the buildings are required to be 100% smoke & vape-free

All of the common areas (pool, picnic, playground, etc) are required to be 100% smoke-free

All of the common areas (pool, picnic, playground, et) are required to be 100% smoke & vape-free

How many buildings are covered under this policy?

How many units are covered under this policy?

Is your tobacco policy included in your lease agreement?

Yes

Clear selection

Are you in need of FREE smoke/vape-free property signage or window clings for your property?

Yes

Clear selection

How many metal signs and or clings would you need?

Would you like to be added to our list of smoke/vape-free housing options in Sarpy & Cass County?

Yes

Clear selection

Is your complex considering implementing a tobacco policy?

Yes

Clear selection

Would you like to be contacted with free information on how to implement or strengthen your tobacco policy?

Yes

Clear selection

Would you like to subscribe to T.E.A.M.’s monthly e-newsletter? *

Yes

Submit

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