Documenting Your Smoke-Free Housing Efforts

This form can be used to track of everything you do or say to resolve problems with tobacco smoke intrusion in your unit. Be as specific as possible and include names, dates, location, witnesses, etc. and keep copies of any correspondence. This type of information may be helpful when contacting management and will likely be necessary to file a Federal Housing Act complaint or pursue a lawsuit.

Date, time, location (if applicable)


Type of communication (letter, phone call, e-mail, etc.)


Who did you talk to or write to?

What was the purpose and what did you ask for?


What happened?
































Provided by GASP of Colorado (Group to Alleviate Smoking Pollution)