Orange County NC Website
Browse       Search
013 <br /> 19 . How often are you bothered by the public smoking in your building? <br /> a. Always <br /> b. Frequently <br /> c. Occasionally <br /> d. Seldom <br /> e. Never <br /> 20. In what parts of the building are you bothered by the public smoking? <br /> (Check as many as apply) <br /> a. No smoking allowed <br /> b. Not bothered <br /> c. Restrooms <br /> d. Hallways <br /> e. Elevators <br /> f. Stairwells <br /> g. Lobbies <br /> h. Waiting Rooms <br /> i. Reception Areas <br /> _ j . Meeting Rooms <br /> k. Immediate work area <br /> 21. Are you. . . <br /> a. Male <br /> b. Female <br /> 22 . Please denote your race: <br /> a. Black <br /> b. Asian or Pacific Islander <br /> c. White <br /> d. American Indian or Alaskan Native <br /> e. Spanish Surnamed American <br /> f. Other (specify) <br /> 23 . What is your age? <br /> a. 18-25 <br /> b. 26-35 <br /> c. 36-55 <br /> d. Over 55 <br /> 24 . Which of the following best describes your working environment: <br /> a. Predominantly closed, individual office <br /> b. Shared office/work area with limited public or visitor <br /> traffic <br /> c. Open work area with public and visitor traffic <br /> d. Predominantly outdoor/outside field work <br /> e. Varying work areas (combination field/office/clinic or other <br /> work areas) <br /> f. Other (specify) <br /> (OVER) <br /> Page 5 of 6 <br />