Survey Of The Housing Needs Of The Chemically Injured
If you need low-toxicity housing, please take the time to fill out our housing survey. Also, if you know of others who need it, please send them a link to the survey or pass the word along to them. There is both an on-line form and a printable pdf form that can be mailed to us. Do which ever one best suits your needs. If you have questions about the Housing Survey, we encourage you to check out our Frequently Asked Questions (FAQ) page. Click here to go to the FAQ page.
Purpose of the Housing Survey
To evaluate the need for specialized, low-toxicity housing in the chemically injured community.
On-Line Version of the Survey
Below is the on-line survey. Fill out the form, verify you are not a robot, and click "Submit".
On-Line Housing Survey
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