Questionnaire for Air Quality Analysis and Mold Remediation - Investigation of the Air Quality - Montreal - Quebec

Important Questions To Ask You And That we Will Ask You

In order to better understand what you are experiencing and to be able to identify exactly what you need, it is basic for us to determine your exact situation. With this in mind, we have prepared this short ’’Question-Air’’.

Please take the 5-10 minutes needed. The accuracy of your answers will enable us to evaluate your situation well for you. We can then recommend the stages to be followed towards the best solution.

LET US GO TO THE SOURCE AND FIND THE CAUSE OF THE PROBLEM
BIOLOGICAL or CHEMICAL ?

1 - BIOLOGICAL ?
Did your house have any water damage?	yes no
- If so, when ?
- In which area of the house ?
Since when do you live in this house ?
Could you have had some hidden water damage ?	yes no
- When ?
- Where ?
What is the relative humidity in your house ?
Do you have a Hygrostat ?	yes no
Are the floors covered by carpets ?	yes no
Is your ventilation system clean ?	yes no
Are you sure that your ventilation system is not contaminated ?	yes no
What kind of heating system do you have ?
Do you keep animals inside ?	yes no
- How many ?
2 - CHEMICAL ?
Was carpet installed recently ?	yes no
- Under carpets ?	yes no
- Carpet cleaners ?	yes no
Have new pieces of furniture been added ?	yes no
Can the cleaning products be at cause ?	yes no
Any pesticides or other chemicals ?	yes no
Which is the external level of pollution in your district ?
Industrial ? Residential ? Agricultural ?

NOW LET’S FIND THE POSSIBLE PLACES TO BE AFFECTED BY MOLDS
( Visible or not )

1 - BASEMENT ?
Is there a sub- floor ?	yes no
Are the walls insulated ?	yes no
- With what ?
- What kind of finishing ?
Is the ventilation sufficient ?	yes no
Could there be some cracks in the foundations ?	yes no
Do you smell unpleasant odours ?	yes no
2 - FLOORS ?
Could there be a broken or leaky pipe : in the toilet ? in the kitchen ?
Do you have an: air-conditioner ? a humidifyer ? some plants ?
Is it possible that the roof has leaked ?	yes no
Can moisture accumulate in between roofs ?	yes no
- Walls ?	yes no
- Elsewhere ?	yes no

WHICH KINDS OF SYMPTOMS ARE YOU EXPERIENCING ?

ATTENTION PLEASE:

1.	YOUR DOCTOR AND THE HEALTH SPECIALISTS ARE THE FIRSTS ONES TO BE CONSULTED.
2.	WE ENJOY WORKING WITH YOUR SPECIALISTS, THEY MAKE THE BEST DIAGNOSTICS
3.	OUR ROLE IS TO FIND WHAT AFFECTS YOUR QUALITY OF LIFE IN THE AIR OF YOUR HOUSE OR OFFICE.

THE PROBABLE CAUSES OF SYMPTOMS IN THE AIR

1.	Of respiratory allergies,
2.	Of respiratory tract problems
3.	Of multiple signs of toxicity.

DOES ANYONE IN YOUR HOUSEHOLD HAVE...
asthma	bronchitis	pneumonia
irritation of the throat	irritation of the nose	nasal flows
sneezing	chronic fatigue	headaches
nauseas	fevers	vomiting
diarrhoea	other :

What did you do so far to improve this problem of unhealthy air ?

Have you discussed with your doctor about the possibility of mold in your house ?

yes no

Would you like us to give him some information that comes from l’Institut National de Santé des Québécois ?

yes no

Would you mind asking him if he would like more free information and how he would like to receive it ?

yes no

Dr.
Téléphone
EMail

Is there anything else we could do for you ?

How can we help you ?

Help us help your doctor. With all concerned persons working all together, each one in their speciality, we will be able to find the source of the problem, and help you to improve your quality of life.
Your comments please.

NOUS AURONS BESOIN DE VOS COORDONNÉES POUR COMMUNIQUER AVEC VOUS
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info@air-labs.com

Questionnaire for Air Quality Analysis and Mold Remediation

AIR-LABS Laboratories, 998 Valiquette, Montreal
Quebec, Canada, H4H 2E3
514-341-0000, 1-866-341-0044