1. Choose your Language
2. Fill out the Survey
3. Confirmation
4.Finish
ONE-ON-ONE INTERVENTION SURVEY
This survey will help both the
Mi Casa Sana
program and Communities of Faith to offer support and information for people that want to quit smoking. It will also help us collect information on second hand smoke and its effects. All your answers are confidential and the data will be used for program evaluation purposes only.
Choose your language:
Select Language
English
Spanish