When was your dryer vent last cleaned?
Less than 6 months 6-12 months Over a year ago Never
Do you currently have a dryer vent cover?
Yes No Not sure
How often do you use your dryer weekly?
Daily 3-6 times 1-2 times Less than once
Do you notice lint build-up around vent?
Yes No Sometimes
Have you ever experienced a dryer fire?
Yes No Near miss
Are you interested in a safety inspection?
Yes, immediately Yes, within a month Maybe later No, thank you
All set, how can we reach you?
Name
Email
Phone
(Details here)
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