If you do not want to participate, please fill out this form and we will remove your household from the list.

Decline to Participate Form

Address *

Address

City

State/Province

Zip/Postal

Household Number *

Household Number. Your household number can be found on the bottom leftside of the ODH postcard. Click here for more detail.

Please check this box if you are declining to participate. *

I decline to participate.

Why are you declining? *

I don’t expect to be home when the team visits.

I don’t want to participate.

I have another reason:I have another reason:

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