IAQ Assistance Request

Indoor Air Quality Help Request Form

Please enter the information about your indoor air quality concern. A member of the Industrial Hygiene and Environmental Compliance Group (ECIH) will be in touch with you within 48 hours. Please do not submit duplicate requests for the same concern.

All fields must be filled out.



Contact Information
Name:
Phone Number:
Email Address:
Supervisor's Name:
Department:
Building:
Room Number:
Building Proctor:*
Nature of the Complaint
Brief Description of Problem: (e.g. My office smells like diesel.)
Symptoms Suffered:(e.g. headaches)
First Occurence: (mm/dd/yyyy)
How often do you experience these symptoms/conditions?

*If you do not know the name of your building proctor, click here to download the Building Proctor List