<%@ Language=VBScript %> <% Option Explicit Response.Buffer = True %> Indoor Mold Contamination - Home Health Science, Inc. - Mold Spore Testing Services Made Easy. <% IF Request("LotNumberCheck") = "" And Request("ZipCode") = "" Then %>


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Enter Your MoldCheck™ Results!

Thank you for taking the time to complete our short confidential survey. Please complete the following and click "Submit".

This database is the first-of-its-kind effort to develop a national database on the question of the relationship between indoor mold spore levels and sick building / sick home syndrome conditions, which yield chronic year round indoor allergy type symptoms and onset of asthma flare-ups or episodes.

Updates - Since the year 2002 is the start-up year for this database, the data sorting, computing, and posting will be updated periodically. When statistically sufficient data is logged in, the results will be posted in a real-time sorted update.

Share Your Data - Confidentially

We only want your data, not your name or address for this survey.

* = Required

<%'FORM BEGIN%>
Please Select Your Country:
*Please Enter Your Zip or Postal Code:
*Kit Lot Number: (Found on Your MoldCheck™ Box.)
*Test Date:
Month: Day: Year:
Days since it rained prior to your test:
Outdoor film background count (spores/hr):
*Lowest Indoor Count:
*Highest Indoor Count:
*Average Indoor Count:
(Add all nine Indoor Counts and divide by 9 to obtain the Average Indoor Count.)
*How old is the building?: Less than 6 Years 7-10 Years Over 10 Years
*Did this kit help you locate the source of growing mold within your building?
[Check if Yes]
Was the building recently flooded by rising flood waters?:
[Check if Yes]
Were parts of the building recently saturated by Fire Department water activity?:
[Check if Yes]
Did you find an indoor water leak or condensation problem?: 
[Check if Yes]
Where did you find the water leak? [Check All That Apply]:
Roof Sewer Pipe Gutter
Windows Water Pipe Dryer Vent
Washer Tub/Shower/Toilet Doors
Basement Concrete Slab Water Tank/Heater
Condensation on Walls Crawl Space
Where did you find the mold growing?
[In, On, Around, Under, Behind - Check All That Apply]:
Rug Under Linoleum Behind Wallpaper
Wallboard Closet Stored Boxes, Papers, etc.
Items in Basement Molding Bathroom Tile
Toilet Area Sink Area Crawl Space Wood
Attic Wood Basement Woodwork  
What are the major health complaints by you or others in this building? [Check All That Apply]:
Asthma (Wheezing) Sinusitis (Ache/Infection)
Rhinitis (Runny Nose) Headache
Burning Eyes Itchy Eyes
Itchy Skin Forgetfulness
Chronic Cough Dizziness
Lethargy/Fatigue Nose Bleeds by occupants or pets
Please enter any comments you would like to share:

<% 'VALIDATE LOT NUMBER Else IF Request("LotNumberCheck") > "" Then Dim strConnect, objRSLot, objRS, strSQL, IDCheck, ID, Cntry 'Create Connection Dim dsn dsn = "moldch.moldcheck" Set strConnect = Server.CreateObject("ADODB.Connection") strConnect.Open dsn 'Open Lot Number Table set objRSLot= server.createobject("adodb.recordset") strSQL = "SELECT * FROM LotNumbers" objRSLot.Open strSQL,strConnect,adOpenDynamic,adLockOptimistic 'Check Record IDCheck = Trim(Request("LotNumberCheck")) IDCheck = "'" & IDCheck & "'" objRSLot.MoveFirst objRSLot.Filter = "LotNumber = " & IDCheck While Not objRSLot.EOF ID = objRSLot("LotNumber") objRSLot.Close Set objRSLot = Nothing 'strConnect.Close 'Set strConnect = Nothing 'Response.Redirect "MoldDataAdd.asp?ID=" & ID & "&" & "ZipCode=" & Request("ZipCode") & "&" & "Cntry=" & Request("Country") 'ADD MOLD DATA 'Open Mold Data Table set objRS= server.createobject("ADODB.Recordset") objRS.Open "MoldData", strConnect,adOpenDynamic,adLockOptimistic 'Add Record objRS.addnew objRS("LotNum") = ID objRS("TestDate") = Request("TestDateYear") & "/" & Request("TestDateMonth") & "/" & Request("TestDateDay") 'If (Request("StartTime1") = "" Or Request("StartTime2") = "") Then 'Else ' objRS("StartTime") = Trim(Request("StartTime1")) & ":" & Trim(Request("StartTime2")) & " " & Request("StartTimeAMPM") 'End If objRS("LastRain") = Trim(Request("LastRain")) objRS("OutdoorCT") = Trim(Request("OutdoorCT")) objRS("LowestIndCt") = Trim(Request("LowestIndCt")) objRS("HighestIndCt") = Trim(Request("HighestIndCt")) objRS("AverageIndCt") = Trim(Request("AverageIndCt")) objRS("AgeofBuilding") = Request.Form("AgeofBuilding") If Request.Form("HelpLocate") = 1 Then objRS("HelpLocate") = 1 End If If Request.Form("Rug") = 1 Then objRS("Rug") = 1 End If If Request.Form("Linoleum") = 1 Then objRS("Linoleum") = 1 End If If Request.Form("Wallpaper") = 1 Then objRS("Wallpaper") = 1 End If If Request.Form("Wallboard") = 1 Then objRS("Wallboard") = 1 End If If Request.Form("Closet") = 1 Then objRS("Closet") = 1 End If If Request.Form("StoredBoxesPapersetc") = 1 Then objRS("StoredBoxesPapersetc") = 1 End If If Request.Form("ItemsinCellar") = 1 Then objRS("ItemsinCellar") = 1 End If If Request.Form("Molding") = 1 Then objRS("Molding") = 1 End If If Request.Form("BathroomTile") = 1 Then objRS("BathroomTile") = 1 End If If Request.Form("ToiletArea") = 1 Then objRS("ToiletArea") = 1 End If If Request.Form("SinkArea") = 1 Then objRS("SinkArea") = 1 End If If Request.Form("CrawlSpaceWood") = 1 Then objRS("CrawlSpaceWood") = 1 End If If Request.Form("AtticWood") = 1 Then objRS("AtticWood") = 1 End If If Request.Form("BasementWoodwork") = 1 Then objRS("BasementWoodwork") = 1 End If If Request.Form("Flooded") = 1 Then objRS("Flooded") = 1 End If If Request.Form("FireDept") = 1 Then objRS("FireDept") = 1 End If If Request.Form("Leak") = 1 Then objRS("Leak") = 1 End If If Request.Form("RoofLeak") = 1 Then objRS("RoofLeak") = 1 objRS("Leak") = 1 End If If Request.Form("SewerPipeLeak") = 1 Then objRS("SewerPipeLeak") = 1 objRS("Leak") = 1 End If If Request.Form("GutterLeak") = 1 Then objRS("GutterLeak") = 1 objRS("Leak") = 1 End If If Request.Form("WindowsLeak") = 1 Then objRS("WindowsLeak") = 1 objRS("Leak") = 1 End If If Request.Form("WaterPipeLeak") = 1 Then objRS("WaterPipeLeak") = 1 objRS("Leak") = 1 End If If Request.Form("DryerVentLeak") = 1 Then objRS("DryerVentLeak") = 1 objRS("Leak") = 1 End If If Request.Form("WasherLeak") = 1 Then objRS("WasherLeak") = 1 objRS("Leak") = 1 End If If Request.Form("TubShowerToiletLeak") = 1 Then objRS("TubShowerToiletLeak") = 1 objRS("Leak") = 1 End If If Request.Form("DoorsLeak") = 1 Then objRS("DoorsLeak") = 1 objRS("Leak") = 1 End If If Request.Form("CellarLeak") = 1 Then objRS("CellarLeak") = 1 objRS("Leak") = 1 End If If Request.Form("ConcreteSlabLeak") = 1 Then objRS("ConcreteSlabLeak") = 1 objRS("Leak") = 1 End If If Request.Form("WaterTankHeaterLeak") = 1 Then objRS("WaterTankHeaterLeak") = 1 objRS("Leak") = 1 End If If Request.Form("CondensationonWallsLeak") = 1 Then objRS("CondensationonWallsLeak") = 1 objRS("Leak") = 1 End If If Request.Form("CrawlSpace") = 1 Then objRS("CrawlSpace") = 1 objRS("Leak") = 1 End If If Request.Form("Asthma") = 1 Then objRS("Asthma") = 1 End If If Request.Form("Rhinitis") = 1 Then objRS("Rhinitis") = 1 End If If Request.Form("BurningEyes") = 1 Then objRS("BurningEyes") = 1 End If If Request.Form("ItchySkin") = 1 Then objRS("ItchySkin") = 1 End If If Request.Form("ChronicCough") = 1 Then objRS("ChronicCough") = 1 End If If Request.Form("LethargyFatigue") = 1 Then objRS("LethargyFatigue") = 1 End If If Request.Form("Sinusitis") = 1 Then objRS("Sinusitis") = 1 End If If Request.Form("Headache") = 1 Then objRS("Headache") = 1 End If If Request.Form("ItchyEyes") = 1 Then objRS("ItchyEyes") = 1 End If If Request.Form("Forgetfulness") = 1 Then objRS("Forgetfulness") = 1 End If If Request.Form("Dizziness") = 1 Then objRS("Dizziness") = 1 End If If Request.Form("NoseBleeds") = 1 Then objRS("NoseBleeds") = 1 End If objRS("Zip") = Trim(Request("ZipCode")) objRS("Cntry") = Request("Country") objRS("Comments") = Trim(Request("Comments")) objRS("DatePosted") = Date objRS.update If Err.Number = 0 Then objRS.Close Set objRS = Nothing strConnect.Close Set strConnect = Nothing Response.Redirect "MoldDataThankYou.asp" Response.End End If Wend 'objRS.Close 'Set objRS = Nothing strConnect.Close Set strConnect = Nothing Response.Redirect "MoldDataError.asp?ID=" & 180 & "&" & "IDCheck=" & Request("LotNumberCheck") End IF End If %>