Do you think your home is affecting your health?

Hayward Score will help you find out. Your answers to the survey will help us understand the important characteristics of your home and how you live in your home. From there we will generate a detailed report that will help you understand your indoor air quality and how you can improve your air and your health!

Climate Zone

Let’s get started.

Climate makes a big difference in how your home handles everything from excess moisture and dust to pets and pests, so it is important for us to know where you live. U.S. only, please.


The number of people and pets in your house can have a significant impact on indoor air quality. Let us know how many people live in your home.

  • Everyone, including children.

  • Please include dogs, cats, and rabbits, but don't include birds or fish.

General Home Information

The more we know about your house the better! Details about your home make a difference so if you are not sure about something, you should do some investigation before you answer. If you still are not sure, take your best guess.

  • A:400.1, A:400.2, A:400.3

  • Please include basements, but don't include attics.

  • As best you know.

  • Please include your basement.

  • Please include your basement.

  • What type of exterior walls does your home have?Q: 435

    Please check all that apply.

  • Is the exterior of your house mostly in the sun or the shade? Q: 445
  • Please select all of the features that are in your home? Q: 450
  • Describe your crawlspace.Q: 455

    If you have a sealed crawlspace, please select one option below

    Please select only one.

  • Describe your basement – both what it looks like and if it is wet, damp, or dry. Q: 460

    Please select one.

    Please select one.

  • Please describe what kind of fireplace you have and how often you use it. (If you have more than one fireplace, answer for the one you use most often)Q: 465

    Please select one.

    Please select one.

  • What is the age of all/majority of your wall-to-wall carpeting?Q: 470
  • Please describe the primary heating system in your home.Q: 475
  • Is your heating?Q: 480
  • Where is your central forced air system located?Q: 485
  • Please describe the primary cooling system in your home.Q: 490
  • Where is your forced air cooling system located?Q: 491
  • Do you typically keep one or more windows open?Q: 495


When you renovate your home, you change your indoor air. Even small remodeling projects can have a big impact by increasing dust and chemicals from the off-gassing of new building materials, paint, furniture, and carpet. And an energy retrofit, which might cut your power bill, tightens up your home so less fresh air circulates. Please tell us how your home has been changed.

  • Is your house currently being remodeled or renovated?Q: 502
  • In the last 10 years, has your home been significantly remodeled or renovated?Q: 500

    i.e. major changes only, ignore cosmetic or minor activity.

  • Has your home ever had an energy retrofit?Q: 510


According to the EPA outdoor pollutants can be 2-5x (and in some cases up to 100x) more concentrated indoors than outdoors where you spend 90% of your time. If you let us know what is going on outside your home, we can understand what may be getting inside your home.

  • Do you live within 1/2 mile of any of the following?Q: 600

    Please select all that apply.

  • Do you live 1 block from any of the following or can you smell any of the following inside your home?Q: 605

    Please select all that apply.



    Moisture is one of the most damaging things that can happen to your home causing not only mold and mildew but also structural decay. Besides obvious issues like leaks and flooding, everyday tasks like cooking and showering can cause excess moisture. The next few questions will help us assess the moisture load in your home.

  • How many meals do you typically cook at home per week?Q: 610

    Please include breakfast, lunch, and dinner.

  • Please tell us a little bit more about your cooking habits.Q: 615
      Yes No
    Do you cook with a steamer 5+ times per week?
    Do you boil, simmer, and/or use a wok 5+ times per week?
    Do you cook with gas?
    Do you usually run the range hood while cooking?
    Do you have a recirculating range hood (one that does not vent to the outside)?


  • How many times a week do you and your family members take showers longer than 10 minutes?Q: 620
  • Please tell us a little more about moisture in your home. Do you/your family most often:Q: 625
      Yes No
    Run the bath fan while showering?
    Run a humidifier in one or more rooms?
    Use a steam shower?
    Use an indoor jacuzzi or spa tub?
    Notice condensation on walls or ceilings?
    Notice condensation in your laundry room?
  • Leaks of any kind are an obvious source of moisture and mold, not to mention damage if they are significant or go undetected. Even leaks that you think have been fixed can continue to cause problems. Help us understand the “leak” history of your house.

  • Water leaks and intrusion can also be a major source of dampness. To the best of your knowledge has your home had any water leaks/damage in the past 2 years?Q: 630
  • Where was the leak(s)?Q: 640

    Please select all that apply.

  • Please describe the type of leak and how it was resolved.Q: 635

    Please select all that apply.

      Fixed Immediately Long-term or Not Fixed Immediately Not applicable
    Small water leak (one-time)
    Small water leak (recurring/on-going)
    Large water leak (flowing/standing water)
    Sewage leak (sink/toilet overflow)
    Sewage leak (backflow from street)
    Flooding or other catastrophic water damage
  • Do you notice any of the following outside your home?Q: 645

    Please select all that apply.

Indoor Conditions

Most people equate a clean, fresh-smelling home with a healthy home. And that is partially true. But if you are cleaning with chemical products, vacuuming without a HEPA filter, or even burning scented candles, you may be unwittingly making your air much less healthy. The next few questions will provide important clues about what may need to be improved.

  • Do you notice any of the following inside your home?Q: 750
      Yes No
    Unpleasant odors or smells
    A lot of dust on surfaces
    Dark/grey dirt or dust on windowsills or near windows
    Water stains on walls and/or ceilings
    Visible mold on walls and/or ceilings
  • What type of vacuum do you own?Q: 755
  • On average how often do you vacuum and/or clean your floors?Q: 760
  • Where do you store cleaning products or chemicals?Q: 765
      Inside the bedroom Inside the house (not in the bedroom) Inside an attached garage Outside the house/detached garage N/A
    Cleaning supplies
    Personal care supplies
    Paint and art supplies
    Fertilizers and pesticides
  • Do you think you have mold in your house?Q: 770


Every home has a few pests. But while usually just a nuisance, pests in your home can be indicators of larger problems, such as mold and decay, and pose serious health hazards themselves. And though traditional pesticides are thought to be effective in preventing and eliminating pests, evidence is increasing that this isn't always the best way. Also, they expose you to chemicals known to be harmful. Knowing what pests are in your home and how you deal with them tells a lot about your indoor air quality.

  • Please indicate any pests that you have inside your home (i.e., in attic, crawlspace, wall cavities)?Q: 800

    Please select all that apply.

  • Do you treat for pests?Q: 805
      Daily/Weekly Monthly/Quarterly Occasionally (1-3x per year) I don’t treat

Health Symptoms


Now that we know a lot about your house and habits we want to know if you have any health-related complaints. These aren’t medical or diagnostic questions we just want to know how you feel in your home. This gives us important clues about how your home might be affecting you and your family.

  • Do you experience any of the following complaints in your home on a frequent or ongoing basis? Q: 900

    Please answer for the person in your home who is most affected, and select all that apply.

  • If you are answering for someone other than yourself is that person a:Q: 902
  • Did any of your symptoms or complaints start or get worse after:Q: 905

    Please select all that apply.

  • Do you experience symptoms or complaints (like sneezing, coughing, or headaches) during or after: Q: 910

    Please select all that apply.

  • Do other members of your household also have similar complaints?:Q: 917

    Their complaints may be the same or different as those previously reported.

  • Do you feel better when you leave the house only to feel worse again when you return? Consider how you feel when you leave the house each day or go away for the weekend or on vacation.Q: 920
  • If you feel better when you leave the house, what symptoms or complaints are relieved?Q: 925
  • Do you or a family member have:Q: 1120

    Please select all that apply.


  • To what extent do you believe your home is negatively impacting your health or the health of your family?Q: 1000
  • Do you have any other concerns about your home we should know about?Q: 1015

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