Zoetic® Survey-Healthy, Safe, Comfortable, Smart, Sustainable and Energy-Efficient.
To help us learn more, please answer the following questions. We will share our results with you. We also offer more in depth surveys
Email address *
How familiar are you with the terms/topics below? *
Very Familar
Somewhat Familar
Not Sure
Never Heard of Term
Interested in Learning More
Passive House
High Performance Home
Air Sealing
HERS Index
Indoor Air Quality
Eenrgy Star
Net-Zero
ERV (energy recovery ventilation)
R value
VOC (volatile organic compounds)
How many adults over age of 30 live in your home? *
Please select any health symptoms you or any family member of your household have had while living in your current house. *
Select any below
Daily/Almost Daily
Weekly
Monthly/Less Frequently
Seasonal
Stuffy or Runny Nose
Headaches, Fatigue
Shortness of Breath
Itching Eyes, Dry Eyes
Joint Pain or Swelling
Muscular Pain
Sleeping Problems
Skin Rashes, Itchy Skin
Sneezing, Itchy throat
Sore Throat
Mental Fatigue
Dry skin
What is your first name? *
Are you sensitive to Electromagnetic Fields (EMF’s)?
Do you or anyone living with you have general fatigue or an un-diagnosed ‘mystery’ illness?
Are you sensitive to lack of sunlight or have Seasonal Affected Disorder?
Are there unpleasant odors in your present home and what are they associated with? *
No Odor
Sometimes
Often
Always
Outside Only
Seasonal
Food Storage
Cigarette Smoke
Mold/Dampness
Cleaning Chemicals
Cooking
Stale Air
Basement
Bathrooms
Upstairs
First Floor
Do you or anyone living with you suffer from an autoimmune disease?
How are the temperature conditions in your current home? *
Too Cold
Too Warm
Drafty
Cold Surfaces
Just Right
Varies Room to Room
In Summer
In Fall
In Spring
In Winter
Does your current house have hot or cold spots from room to room or floor to floor?
Are you concerned about mold?
How many children under the age of 18 live in your home? *
How many adults between the ages of 18 and 30 live in your home? *
How would you rate the energy-efficiency of your home? *
Not Energy Efficient
Very Energy-Efficient
Rank each of the attributes below by importance to you. *
Most important
Somewhat Important
Less Important
Not Important
Healthy
Safe
Comfortable
Smart
Sustainable
Energy-Efficient
Do you or anyone living with you suffer from respiratory illness (i.e. allergies, asthma, etc.)? *
Required
A copy of your responses will be emailed to the address you provided.
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