Housing Security Assessment Questionnaire

Housing Security Assessment Questionnaire
Evaluate the safety and security features of your residence to identify strengths and areas for improvement.
Full Name of Assessor or Resident*
First NameLast Name
Contact Email*
example@example.com
Property Address*
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Residence*
How would you rate the overall security of your residence?*
Please evaluate the following security features present in your home.*
Rows Present Well Maintained Needs Improvement
Deadbolt Locks on Doors
Window Locks
Security Alarm System
Exterior Lighting
Security Cameras
Smoke/Fire Alarms
How secure do you feel in your neighborhood?*

1
2
3
4
5
1 is Not secure, 5 is Very secure
YesNoNot Sure
Fire extinguisher(s)First aid kitEmergency exit planEmergency contact listOther
Please list any additional security concerns or suggestions for improving safety at your residence.
Should be Empty: