Feedback

Share Your Feedback

To contact the Smoke and Tobacco Free Program coordinator, please email breathefree@ucdavis.edu or kclift@ucdavis.edu.

The purpose of this form is to collect feedback and experiences related to implementation of the Smoke and Tobacco Free policy at UC Davis.

Please use this form to report your observations of the policy in action, including general comments, litter related to tobacco use, and/or policy violations.

Your input will be kept private. You can also report anonymously.

Thank you!

1. Reason for your feedback

Reporting litter or policy violation

4. If you are writing about a policy violation, did you approach the violator(s) and remind them of the policy?
5. If yes, did the violator(s) then comply with the policy?

Question of Feedback

We greatly appreciate your feedback. The demographic questions below are entirely optional. They will further help us evaluate the Smoke and Tobacco Free campaign.

8. What is your relationship to the university?
9. On a scale of 1-5, with 1 being "strongly support," what is your degree of support for UC Davis' Smoke and Tobacco Free initiative?
10. Are you currently a smoker and/or tobacco user or a non-smoker/tobacco user?