Registration form Who should register To register for the airAlert service please fill in the form below and return to airAlert, Environmental Protection, Town Hall, Castlefield Road, , , RH2 0SH. Reigate and for airAlert? council handle all postal registrations regardless of which borough you live in. We recommend that you register for Title: Please circle: Mr, Mrs, Miss, Ms, Dr or other airAlert if you have COPD or your asthma Forename/initials: is triggered by air pollution or you are the Surname: parent or carer of someone who suffers Helping you Address: with either of the above. breathe more Postcode: How can I register? Contacting us You can register online at The Surrey airAlert service Which borough would you like to receive alerts for (please circle): www.airalert.info and is provided by seven easily Elmbridge & select Surrey, by post using local authorities in Surrey Reigate & Banstead Tandridge Spelthorne the form opposite, or by (Elmbridge, Epsom and Ewell, calling 01737 276403 or Mole Valley, Spelthorne, Is this service: for you or are you a carer for someone else 01372 474750. Tandridge, Woking, and (tick as applicable) ) in Age: Please circle: 1-5, 6-10, 11-16, 17-25, 26-35, 36-45, 46-55, 56-59 Can I register on someone conjunction with Surrey 60-70, 71+ else’s behalf? County Council and can Do you need the alerts for: Please tick all that apply. Yes you can register if you are be contacted via any of the a parent or carer for someone following methods: Asthma COPD Heart disease Other who is adversely affected by Telephone: 01737 276403 high levels of pollution. Complete ONE of the following to receive airAlerts. or 01372 474750 How would you like to receive the alert (circle one only) Email: airalert@ Voice message (enter number below), reigate-banstead.gov.uk Post: airAlert, Environmental Protection, Town Hall, Please ensure the number given is a direct number and not through a switchboard. Castlefield Road, Reigate, Text message (enter number below), Surrey, RH2 0SH.

To unsubscribe from this Please ensure the number given is a direct number and not through a switchboard. service please e-mail or call Email (enter address below). us using the details above. Free air pollution warning service that helps you Please use the following details for my account: If you need manage your respiratory Username: this leaflet in large condition more effectively Password: print please call All the information you give to us will be processed in accordance with the Data Protection Act 1998. It will be kept confidential and used only to supply or monitor the 01737 276403. Register online now Air Alert service to you.

We will not share your information with any third party, except for the prevention or Tear off here www.airalert.info detection of fraud or crime. We are continually evaluating the service and we would like to know if we can share your information with our partners for this purpose and contact you to ask your views on airAlert and the ways in which it can be improved. Please tick: Yes No For more information or to register online now visit Service for East Surrey, www.airalert.info Spelthorne & Woking What is airAlert? What can I expect How do I sign up? from airAlert? airAlert is a free service provided by the fi ve airAlert messages let you know the airAlert is a completely free service local authorities of East Surrey, together predicted levels of pollution in your area. available to all those who would with Spelthorne, Woking, and Surrey benefi t from air pollution alerts. County Council, to help improve the lives of those who are affected by air pollution. airAlert can help you What should I do when airAlert message The airAlert will detail: There are 4 easy ways to sign up: manage your health I receive an airAlert? These are the type of 1. Registering online at Those affected by asthma, • Avoid areas where pollution messages you will receive. • The level of concern; other respiratory illnesses increases are likely. These messages refl ect Moderate, High or Very High. www.airalert.info/surrey and heart conditions can fi nd government advice on air their health is affected by poor • Be active, but consider pollution levels. • The type of pollution ozone 2. Download the smartphone app air quality. alternative activities for the (O3), particles/dust (PM10), nitrogen dioxide (NO ). period of an alert. Moderate air 2 (android/iOS) at: airAlert is a free text, pollution levels voicemail, e-mail and web • Don’t forget your inhaler • Where the pollution is of www.airalert.info/surrey service that sends you air or medication. those at risk may notice mild most concern (e.g. roadside, pollution alerts when levels effects but these are unlikely non-roadside, rural, urban). 3. Calling us on 01737 276403 in your area increase to a • Contact your health to need action. or 01372 474750 and we will moderate level or above. professional if your • Date and period of the alert. symptoms worsen or if you High air register for you airAlerts are sent out on the require specialist advice pollution levels The number of alerts issued varies from year to year, though day before moderate levels concerning your condition. those at risk may notice 4. Completing and returning the are forecast. The service typically 20 to 50 alerts are signifi cant effects and may issued per year. allows you to receive alerts need to take action. attached form for different locations (i.e home or work). Very high Once you have signed up we will send you a air pollution levels airAlert is particularly welcome message. airAlert runs all year but valuable for those who have the effects on those at risk, messages will only be sent out when pollution chronic respiratory disease described for ‘high’ alerts, or whose asthma is triggered may worsen levels increase to a moderate level or above. by air pollution. “airAlert defi nitely helped me understand the link between air pollution and my health” Tear off here - a user For more information or to register online now visit www.airalert.info