Reporting period
For the purposes of this survey, report information for the year 2019.
What will you need to complete this questionnaire
For size of the building, you can refer to the Building Occupancy Permit, fire protection drawings, or architectural drawings.
Reporting instructions
- Percentages should be rounded to whole numbers.
- When precise figures are not available, provide your best estimates.
- Enter "0" if there is no value to report.
Definitions
Post-secondary institution:
An educational institution that is attended after obtaining a high school diploma or equivalent.
Hospital:
A healthcare institution providing medical and surgical treatment and nursing care for sick or injured people.
Why have you been selected?
You have been selected because Statistics Canada uses a statistical method called sampling. It is an established way to determine characteristics of an entire population by surveying only part of the population.
Hospitals: Few hospitals are present in Canada and we need information from all of them to be able to produce accurate statistics on their energy use at the provincial/territorial level.
Post-secondary institutions: 98% of the post-secondary institutions in Canada were selected as part of a random sample to represent the population of post-secondary institutions.
It is important that all institutions answer to be able to produce accurate statistics on their energy use at the provincial/territorial level.
Who should complete this questionnaire?
This questionnaire should be completed by the person most knowledgeable about the energy consumption and usage of this post-secondary institution or hospital.
i.e., someone who has access to energy bills and knowledge about the structure and details of this institution (e.g., property manager, building manager, facilities and operations manager, building owner).
How do we protect your information?
Statistics Canada is committed to respecting the privacy of consultation participants. All personal information created, held or collected by the agency is protected in accordance with the Privacy Act.
Deadline for completing this questionnaire
Please complete this questionnaire and submit it within 14 days of receipt.
Printing your completed questionnaire
You can print this questionnaire once you have completed and submitted it.
Business or organization and contact information
1. Verify or provide the business or organization's legal and operating name and correct where needed.
Note: Legal name modifications should only be done to correct a spelling error or typo.
Note: Press the help button (?) for additional information.
Legal name:
Operating name (if applicable):
2. Verify or provide the contact information of the designated business or organization contact person for this questionnaire and correct where needed.
Note: The designated contact person is the person who should receive this questionnaire. The designated contact person may not always be the one who actually completes the questionnaire.
First name:
Last name:
Title:
Preferred language of communication
- English
- French
Mailing address (number and street):
City:
Province, territory or state
- 1: Alberta
- 2: British Columbia
- 3: Manitoba
- 4: New Brunswick
- 5: Newfoundland and Labrador
- 6: Northwest Territories
- 7: Nova Scotia
- 8: Nunavut
- 9: Ontario
- 10: Prince Edward Island
- 11: Quebec
- 12: Saskatchewan
- 13: Yukon
- 14: Alabama
- 15: Alaska
- 16: American Samoa
- 17: Arizona
- 18: Arkansas
- 19: California
- 20: Colorado
- 21: Connecticut
- 22: Delaware
- 23: District of Columbia
- 24: Federated States of Micronesia
- 25: Florida
- 26: Georgia
- 27: Guam
- 28: Hawaii
- 29: Idaho
- 30: Illinois
- 31: Indiana
- 32: Iowa
- 33: Kansas
- 34: Kentucky
- 35: Louisiana
- 36: Maine
- 37: Marshall Islands
- 38: Maryland
- 39: Massachusetts
- 40: Michigan
- 41: Minnesota
- 42: Mississippi
- 43: Missouri
- 44: Montana
- 45: Nebraska
- 46: Nevada
- 47: New Hampshire
- 48: New Jersey
- 49: New Mexico
- 50: New York
- 51: North Carolina
- 52: North Dakota
- 53: Northern Mariana Islands
- 54: Ohio
- 55: Oklahoma
- 56: Oregon
- 57: Palau
- 58: Pennsylvania
- 59: Puerto Rico
- 60: Rhode Island
- 61: South Carolina
- 62: South Dakota
- 63: Tennessee
- 64: Texas
- 65: U.S. Minor Outlying Islands
- 66: Utah
- 67: Vermont
- 68: Virgin Islands of the U.S.
- 69: Virginia
- 70: Washington
- 71: West Virginia
- 72: Wisconsin
- 73: Wyoming
Postal code or ZIP code:
Example: A9A 9A9 or 12345-1234
Country
- Canada
- United States
Email address:
Example: user@example@example.gov.ca
Telephone number (including area code):
Example: 123-123-1234
Extension number (if applicable):
Fax number (including area code):
Example: 123-123-1234
3. Verify or provide the current operational status of the business or organization identified by the legal and operating name above.
- Operational
- Not currently operational
Why is this business or organization not currently operational?- Seasonal operations
- When did this business or organization close for the season?
- Date
- When does this business or organization expect to resume operations?
- Date
- When did this business or organization close for the season?
- Ceased operations
- When did this business or organization cease operations?
- Date
- Why did this business or organization cease operations?
- Bankruptcy
- Liquidation
- Dissolution
- Other - Specify the other reasons why the operations ceased
- When did this business or organization cease operations?
- Sold operations
- When was this business or organization sold?
- Date
- What is the legal name of the buyer?
- When was this business or organization sold?
- Amalgamated with other businesses or organizations
- When did this business or organization amalgamate?
- Date
- What is the legal name of the resulting or continuing business or organization?
- What are the legal names of the other amalgamated businesses or organizations?
- When did this business or organization amalgamate?
- Temporarily inactive but will re-open
- When did this business or organization become temporarily inactive?
- Date
- When does this business or organization expect to resume operations?
- Date
- Why is this business or organization temporarily inactive?
- When did this business or organization become temporarily inactive?
- No longer operating due to other reasons
- When did this business or organization cease operations?
- Date
- Why did this business or organization cease operations?
- When did this business or organization cease operations?
- Seasonal operations
4. Verify or provide the current main activity of the business or organization identified by the legal and operating name above.
Note: The described activity was assigned using the North American Industry Classification System (NAICS).
Note: Press the help button (?) for additional information, including a detailed description of this activity complete with example activities and any applicable exclusions.
-Description and examples
- This is the current main activity
- This is not the current main activity
Provide a brief but precise description of this business or organization's main activity:
e.g., breakfast cereal manufacturing, shoe store, software development
Main activity
5. You that this is not the current main activity.
Was this business or organization's main activity ever classified as:
- When did the main activity change?
Date:
Example: YYYY-MM-DD - No
6. Search and select the industry classification code that best corresponds to this business or organization's main activity.
How to search:
- if desired, you can filter the search results by first selecting this business or organization's activity sector
- enter keywords or a brief description that best describes this business or organization main activity
- press the Search button to search the database for an activity that best matches the keywords or description you provided
- then select an activity from the list.
Select this business or organization's activity sector (optional)
- Farming or logging operation
- Construction company or general contractor
- Manufacturer
- Wholesaler
- Retailer
- Provider of passenger or freight transportation
- Provider of investment, savings or insurance products
- Real estate agency, real estate brokerage or leasing company
- Provider of professional, scientific or technical services
- Provider of health care or social services
- Restaurant, bar, hotel, motel, or other lodging establishment
- Other sector
7. You have indicated that the current main activity of this business or organization is:
Are there any other activities that contribute significantly (at least 10%) to this business or organization's revenue?
- Yes, there are other activities
Provide a brief but precise description of this business or organization's secondary activity
e.g., breakfast cereal manufacturing, shoe store, software development - No, that is the only significant activity
8. Approximately what percentage of this business or organization's revenue is generated by each of the following activities?
When precise figures are not available, provide your best estimates.
a: Main activity
Percentage of revenue:
b: Secondary activity
Percentage of revenue:
c: All other activities
Percentage of revenue:
Total percentage:
Institution information
1. Verify or provide the information regarding this institution below and correct where needed.
Note: Modifications should only be done to correct an error.
Institution name:
Mailing address (number and street):
City:
Province or territory:
- Alberta
- British Columbia
- Manitoba
- New Brunswick
- Newfoundland and Labrador
- Northwest Territories
- Nova Scotia
- Nunavut
- Ontario
- Prince Edward Island
- Quebec
- Saskatchewan
- Yukon
Postal code:
Example: A9A 9A9
Contact Person
2. Verify or provide the contact information of the person who is filling out this questionnaire.
Company or Organization:
First name
Last name:
Title:
Preferred language:
1: English
2: French
Email address:
Example: user@example.gov.ca
Telephone number (including area code):
Example: 123-123-1234
Extension number (if applicable):
Mailing address (number and street):
City:
Province, territory or state:
- 1: Alberta
- 2: British Columbia
- 3: Manitoba
- 4: New Brunswick
- 5: Newfoundland and Labrador
- 6: Northwest Territories
- 7: Nova Scotia
- 8: Nunavut
- 9: Ontario
- 10: Prince Edward Island
- 11: Quebec
- 12: Saskatchewan
- 13: Yukon
- 14: Alabama
- 15: Alaska
- 16: American Samoa
- 17: Arizona
- 18: Arkansas
- 19: California
- 20: Colorado
- 21: Connecticut
- 22: Delaware
- 23: District of Columbia
- 24: Federated States of Micronesia
- 25: Florida
- 26: Georgia
- 27: Guam
- 28: Hawaii
- 29: Idaho
- 30: Illinois
- 31: Indiana
- 32: Iowa
- 33: Kansas
- 34: Kentucky
- 35: Louisiana
- 36: Maine
- 37: Marshall Islands
- 38: Maryland
- 39: Massachusetts
- 40: Michigan
- 41: Minnesota
- 42: Mississippi
- 43: Missouri
- 44: Montana
- 45: Nebraska
- 46: Nevada
- 47: New Hampshire
- 48: New Jersey
- 49: New Mexico
- 50: New York
- 51: North Carolina
- 52: North Dakota
- 53: Northern Mariana Islands
- 54: Ohio
- 55: Oklahoma
- 56: Oregon
- 57: Palau
- 58: Pennsylvania
- 59: Puerto Rico
- 60: Rhode Island
- 61: South Carolina
- 62: South Dakota
- 63: Tennessee
- 64: Texas
- 65: U.S. Minor Outlying Islands
- 66: Utah
- 67: Vermont
- 68: Virgin Islands of the U.S.
- 69: Virginia
- 70: Washington
- 71: West Virginia
- 72: Wisconsin
- 73: Wyoming
Postal code or ZIP code:
Example: A9A 9A9 or 12345-1234
Country:
- Canada
- United States
- Other
Institution information
3. On December 31st, 2019, which of the following categories described this institution?
Post-secondary institution:
An educational institution that is attended after obtaining a high school diploma or equivalent.
Hospital:
A healthcare institution providing medical and surgical treatment and nursing care for sick or injured people.
Select all that apply.
- Post-secondary institution
- Hospital
OR - None of the above
4. On December 31st, 2019, which of the following categories best described this post-secondary institution?
1: University
An establishment primarily engaged in providing academic courses and granting degrees at the bachelor or graduate levels. The requirement for admission is at least a high school diploma or equivalent general academic training for baccalaureate programs, and often a baccalaureate degree for professional or graduate programs.
2: College
An establishment primarily engaged in providing academic or academic and technical courses and granting associates degrees, certificates and or diplomas, the requirement for admission to an associate or equivalent degree program is at least a high school diploma or equivalent general academic training.
3: Technical school
An establishment primarily engaged in providing technical training in a variety of technical subjects and the science behind the occupation. Training often leads to non-academic certification. Correspondence schools are also included.
4: Trade or Vocational school
An establishment primarily engaged in providing vocational training in a variety of trades focussing on hands-on application of skill. Training often leads to non-academic certification. Correspondence schools are also included.
5: Cégep (Collège d'enseignement général et professionnel)
A publicly funded post-secondary education establishment attended after high school and before university, exclusive to the province of Quebec's education system.
6: Adult education
An establishment primarily engaged in providing elementary, intermediate, or secondary (Kindergarten to Grade 12 or secondary 5 in Québec) education to adult students.
7: Other
Specify other post-secondary institution type:
Campus characteristics
5. On December 31st, 2019, did this institution have multiple campuses?
Campus:
A collection of buildings belonging to one organization. The campus does not have to be contiguous, only belonging to a grouping of buildings in close proximity that is apparent to the public, i.e., as it is represented on campus maps.
- Yes
- On December 31st, 2019, how many campuses did this institution have?
Total number of campuses
Does each campus have a separate contact person?- Yes
- No
- No
6. Please provide the names of the campuses associated with this institution.
If each campus has a unique identifier, please replace the following information with the name of each campus.
Campus name or unique identifier
1 :
Remove campus
2 :
Remove campus
Add campus name or unique identifier
1 :
Add campus
7. On December 31st, 2019, how many buildings from this institution were located on this campus?
Building:
A structure totally enclosed by walls extending from a foundation to a roof.
Campus:
A collection of buildings belonging to one organization. The campus does not have to be contiguous, only belonging to a grouping of buildings in close proximity that is apparent to the public, i.e., as it is represented on campus maps.
Total number of buildings located on this campus:
8. On December 31st, 2019, what was the total indoor floor area of all buildings located on this campus?
Campus:
A collection of buildings belonging to one organization. The campus does not have to be contiguous, only belonging to a grouping of buildings in close proximity that is apparent to the public, i.e., as it is represented on campus maps.
When precise figures are not available, please provide your best estimate.
Unit of measure:
- Square feet
- Square metres
Total indoor floor area of all buildings located on this campus:
Area of campus
9. On December 31st, 2019, what was the total land area of this campus?
Campus:
A collection of buildings belonging to one organization. The campus does not have to be contiguous, only belonging to a grouping of buildings in close proximity that is apparent to the public, i.e., as it is represented on campus maps.
When precise figures are not available, please provide your best estimate.
Unit of measure:
- Acres
- Hectares
Total land area of this campus:
Hospital types
10. On December 31st, 2019, which of the following categories described the hospital on this campus?
Select all that apply.
- General medical and surgical hospital
An institution that is primarily engaged in providing diagnostic, therapeutic and rehabilitative services for medical diagnosis, treatment including surgery, and care to injured, disabled, or sick individuals, by or under the supervision of physicians. - Long term acute care hospital
A certified institution that provides medical acute care for extended inpatient days, defined as an average of 25 days or more. - Critical access hospital
A rural community hospital that receives cost-based reimbursement. - Cancer centre
A hospital that specializes only in the care of patients with cancer. - Behavioural care facility
An outpatient treatment centre for patients with psychiatric or mental disorders, such as Alzheimer's or other developmental disabilities.
Include outpatient and psychiatric counseling for patients with a substance abuse problem. - Rehabilitation centre or hospital
A recovery facility oriented toward long-term treatment and training of sick or injured persons. Rehabilitation centres specialize in physical therapy for accident, trauma or stroke victims. - Psychiatric hospital
A medical institution where the primary function is to treat patients who have psychiatric related illnesses. - Post-acute care or skilled nursing
A medical institution that provides non-acute medical and skilled nursing care services, therapy, and social services under the supervision of a licensed registered nurse on a 24-hour basis. - Veterinary
A facility that specializes in the care of animals. - Other specialty hospital
e.g., cardiac, orthopedic, children's or women's hospital
Specify other specialty hospital type:
11. On December 31st, 2019, what was the percentage of floor space used for the following hospital types on this campus?
Provide your best estimate rounded to the nearest percentage.
a: General medical and surgical hospital
Percentage of floor space:
b: Long term acute care hospital
Percentage of floor space:
c: Critical access hospital
Percentage of floor space:
d: Cancer centre
Percentage of floor space:
e: Behavioural care facility
Percentage of floor space:
f: Rehabilitation centre or hospital
Percentage of floor space:
g: Psychiatric hospital
Percentage of floor space:
h: Post-acute care or skilled nursing
Percentage of floor space:
i: Veterinary
Percentage of floor space:
j: Other hospital type
Percentage of floor space:
Hospital area type
12. On December 31st, 2019, what types of hospital areas, as defined by CAN/CSA Z317, 2-15, did the hospital on this campus have?
CAN /CSA Z317, 2-15: CSA developed standard with regard to special requirement for heating, ventilation and air-conditioning (HVAC) systems in health care facilities. CSA and the National Standards of Canada identified categorizations of health cares service delivery according to stringency of HVAC and environmental requirements.
Select all that apply.
1: Type I
An area where there are stringent requirements due to the invasiveness of procedures, the level of risk of morbidity and mortality, or the level of risk of adverse outcomes to care providers.
What was the total floor area of the hospital categorized as Type I?
When precise figures are not available, please provide your best estimate.
Unit of measure:
1: Square feet
2: Square metres
Total floor area categorized as Type I:
2: Type II
A patient care area intended to provide support services.
e.g., lab, medical device reprocessing departments
What was the total floor area of the hospital categorized as Type II?
When precise figures are not available, please provide your best estimate.
Unit of measure:
1: Square feet
2: Square metres
Total floor area categorized as Type II:
3: Type III
An area where all support services are not designated as Type I or Type II.
What was the total floor area of the hospital categorized as Type III?
When precise figures are not available, please provide your best estimate.
Unit of measure:
1: Square feet
2: Square metres
Total floor area categorized as Type III:
Activity or function
13. On December 31st, 2019, which of the following activities or functions occurred in all buildings located on this campus?
Select all that apply.
- Classrooms, conference rooms, and theatres
Include non-specialized meeting, teaching, studying, and assembly space. - Cafeteria and food services
Space used for cooking, food preparation, and refrigeration space.
e.g., fast food restaurant, residence cafeteria - Retail
Space designated to the sale of food and non-food goods requiring little to no cooking, refrigeration, or food preparation.
e.g., convenience store, book store, grocery store - Laboratory
Specialized instruction or research space that is not suitable for general use.
i.e., caters to a specific program or group - Library
Space used to store and manage collections of literary and artistic materials (e.g., books, periodicals, newspapers, films) that can be used for reference or lending.
Include library study areas. - Office space
Administrative office space.
e.g., professor's offices, admin offices, student group offices, computer server rooms - Athletics facilities
All indoor athletic and recreational space.
e.g., ice rinks, gyms, weight training, curling rinks, pools - Warehouse
General storage space.
Include refrigerated and non-refrigerated warehouse space. - Residences
Student living accommodations.
Include sanitary amenities such as showers, washrooms, and laundry facilities. - Stadium
Include both outdoor open-air and closed stadium. - Repair shops and manufacturing
Technical area where repair, assembly, or fabrication occurs. - Other
Include non-specific shared spaces.
e.g., atriums, foyers
Specify other activity or function 1:
Specify other activity or function 2:
Specify other activity or function 3:
Specify other activity or function 4:
Specify other activity or function 5:
Specify other activity or function 6:
14. On December 31st, 2019, what was the percentage of floor space used for the following activities or functions at this campus?
Provide your best estimate rounded to the nearest percentage.
a: Classrooms, conference rooms, and theatres
Include non-specialized meeting, teaching, studying, and assembly space.
Percentage of floor space:
b: Cafeteria and food services
Space used for cooking, food preparation, and refrigeration space.
e.g., fast food restaurant, residence cafeteria
Percentage of floor space:
c: Retail
Space designated to the sale of food and non-food goods requiring little to no cooking, refrigeration, or food preparation.
e.g., convenience store, book store, grocery store
Percentage of floor space:
d: Laboratory
Specialized instruction or research space that is not suitable for general use.
i.e., caters to a specific program or group
Percentage of floor space:
e: Library
Space used to store and manage collections of literary and artistic materials (e.g., books, periodicals, newspapers, films) that can be used for reference or lending.
Include library study areas.
Percentage of floor space:
f: Office space
Administrative office space.
e.g., professor's offices, admin offices, student group offices, computer server rooms
Percentage of floor space:
g: Athletics facilities
All indoor athletic and recreational space.
e.g., ice rinks, gyms, weight training, curling rinks, pools
Percentage of floor space:
h: Warehouse
General storage space.
Include refrigerated and non-refrigerated warehouse space.
Percentage of floor space:
i: Residences
Student living accommodations.
Include sanitary amenities such as showers, washrooms, and laundry facilities.
Percentage of floor space:
j: Stadium
Include both outdoor open-air and closed stadium.
Percentage of floor space:
k: Repair shops and manufacturing
Technical area where repair, assembly, or fabrication occurs.
Percentage of floor space:
l: Other activity or function 1
Percentage of floor space:
m: Other activity or function 2
Percentage of floor space:
n: Other activity or function 3
Percentage of floor space:
o: Other activity or function 4
Percentage of floor space:
p: Other activity or function 5
Percentage of floor space:
q: Other activity or function 6
Percentage of floor space:
Total of floor space
Contact person
Note: In the future, a questionnaire will be sent with questions on campus characteristics, energy consumption and usage, campus modifications, and campus type specific questions.
The designated contact person should be the person who is best suited to answer this questionnaire. This person would be someone who is knowledgeable about the energy consumption and usage of this campus.
i.e., someone who has access to energy bills and knowledge about the structure and details of this campus (e.g., property manager, building manager, facilities manager, building owner).
15. Is the contact person the best person to fill out the survey for all campuses?
- Yes
- No
Who is the best person to fill out the survey?
Company or Organization:
First name:
Last name:
Title:
Preferred language:
- English
- French
Email address:
Example: user@example.gov.ca
Telephone number (including area code):
Example: 123-123-1234
Extension number (if applicable):
Mailing address (number and street):
City:
Province, territory or state:
- 1: Alberta
- 2: British Columbia
- 3: Manitoba
- 4: New Brunswick
- 5: Newfoundland and Labrador
- 6: Northwest Territories
- 7: Nova Scotia
- 8: Nunavut
- 9: Ontario
- 10: Prince Edward Island
- 11: Quebec
- 12: Saskatchewan
- 13: Yukon
- 14: Alabama
- 15: Alaska
- 16: American Samoa
- 17: Arizona
- 18: Arkansas
- 19: California
- 20: Colorado
- 21: Connecticut
- 22: Delaware
- 23: District of Columbia
- 24: Federated States of Micronesia
- 25: Florida
- 26: Georgia
- 27: Guam
- 28: Hawaii
- 29: Idaho
- 30: Illinois
- 31: Indiana
- 32: Iowa
- 33: Kansas
- 34: Kentucky
- 35: Louisiana
- 36: Maine
- 37: Marshall Islands
- 38: Maryland
- 39: Massachusetts
- 40: Michigan
- 41: Minnesota
- 42: Mississippi
- 43: Missouri
- 44: Montana
- 45: Nebraska
- 46: Nevada
- 47: New Hampshire
- 48: New Jersey
- 49: New Mexico
- 50: New York
- 51: North Carolina
- 52: North Dakota
- 53: Northern Mariana Islands
- 54: Ohio
- 55: Oklahoma
- 56: Oregon
- 57: Palau
- 58: Pennsylvania
- 59: Puerto Rico
- 60: Rhode Island
- 61: South Carolina
- 62: South Dakota
- 63: Tennessee
- 64: Texas
- 65: U.S. Minor Outlying Islands
- 66: Utah
- 67: Vermont
- 68: Virgin Islands of the U.S.
- 69: Virginia
- 70: Washington
- 71: West Virginia
- 72: Wisconsin
- 73: Wyoming
Postal code or ZIP code:
Example: A9A 9A9 or 12345-1234
Country:
- Canada
- United States
- Other
Campus characteristics
16. On December 31st, 2019, how many buildings from this institution were located on this campus?
Building:
A structure totally enclosed by walls extending from a foundation to a roof.
Campus:
A collection of buildings belonging to one organization. The campus does not have to be contiguous, only belonging to a grouping of buildings in close proximity that is apparent to the public, i.e., as it is represented on campus maps.
Total number of buildings located on this campus:
17. On December 31st, 2019, what was the total indoor floor area of all buildings located on this campus?
Campus:
A collection of buildings belonging to one organization. The campus does not have to be contiguous, only belonging to a grouping of buildings in close proximity that is apparent to the public, i.e., as it is represented on campus maps.
When precise figures are not available, please provide your best estimate.
Unit of measure:
- Square feet
- Square metres
Total indoor floor area of all buildings located on this campus:
Area of campus
18. On December 31st, 2019, what was the total land area of this campus?
Campus:
A collection of buildings belonging to one organization. The campus does not have to be contiguous, only belonging to a grouping of buildings in close proximity that is apparent to the public, i.e., as it is represented on campus maps.
When precise figures are not available, please provide your best estimate.
Unit of measure:
- Acres
- Hectares
Total land area of this campus:
Hospital types
19. On December 31st, 2019, which of the following categories described the hospital on this campus?
Select all that apply.
- General medical and surgical hospital
An institution that is primarily engaged in providing diagnostic, therapeutic and rehabilitative services for medical diagnosis, treatment including surgery, and care to injured, disabled, or sick individuals, by or under the supervision of physicians. - Long term acute care hospital
A certified institution that provides medical acute care for extended inpatient days, defined as an average of 25 days or more. - Critical access hospital
A rural community hospital that receives cost-based reimbursement. - Cancer centre
A hospital that specializes only in the care of patients with cancer. - Behavioural care facility
An outpatient treatment centre for patients with psychiatric or mental disorders, such as Alzheimer's or other developmental disabilities.
Include outpatient and psychiatric counseling for patients with a substance abuse problem. - Rehabilitation centre or hospital
A recovery facility oriented toward long-term treatment and training of sick or injured persons. Rehabilitation centres specialize in physical therapy for accident, trauma or stroke victims. - Psychiatric hospital
A medical institution where the primary function is to treat patients who have psychiatric related illnesses. - Post-acute care or skilled nursing
A medical institution that provides non-acute medical and skilled nursing care services, therapy, and social services under the supervision of a licensed registered nurse on a 24-hour basis. - Veterinary
A facility that specializes in the care of animals. - Other specialty hospital
e.g., cardiac, orthopedic, children's or women's hospital
Specify other specialty hospital type:
20. On December 31st, 2019, what was the percentage of floor space used for the following hospital types on this campus?
Provide your best estimate rounded to the nearest percentage.
a: General medical and surgical hospital
Percentage of floor space:
b: Long term acute care hospital
Percentage of floor space:
c: Critical access hospital
Percentage of floor space:
d: Cancer centre
Percentage of floor space:
e: Behavioural care facility
Percentage of floor space:
f: Rehabilitation centre or hospital
Percentage of floor space:
g: Psychiatric hospital
Percentage of floor space:
h: Post-acute care or skilled nursing
Percentage of floor space:
i: Veterinary
Percentage of floor space:
j: Other hospital type
Percentage of floor space:
Hospital area type
21. On December 31st, 2019, what types of hospital areas, as defined by CAN/CSA Z317, 2-15, did the hospital on this campus have?
CAN /CSA Z317, 2-15: CSA developed standard with regard to special requirement for heating, ventilation and air-conditioning (HVAC) systems in health care facilities. CSA and the National Standards of Canada identified categorizations of health cares service delivery according to stringency of HVAC and environmental requirements.
Select all that apply.
1: Type I
An area where there are stringent requirements due to the invasiveness of procedures, the level of risk of morbidity and mortality, or the level of risk of adverse outcomes to care providers.
What was the total floor area of the hospital categorized as Type I?
When precise figures are not available, please provide your best estimate.
Unit of measure:
1: Square feet
2: Square metres
Total floor area categorized as Type I:
2: Type II
A patient care area intended to provide support services.
e.g., lab, medical device reprocessing departments
What was the total floor area of the hospital categorized as Type II?
When precise figures are not available, please provide your best estimate.
Unit of measure:
1: Square feet
2: Square metres
Total floor area categorized as Type II:
3: Type III
An area where all support services are not designated as Type I or Type II.
What was the total floor area of the hospital categorized as Type III?
When precise figures are not available, please provide your best estimate.
Unit of measure:
1: Square feet
2: Square metres
Total floor area categorized as Type III:
Activity or function
22. On December 31st, 2019, which of the following activities or functions occurred in all buildings located on this campus?
Select all that apply.
- Classrooms, conference rooms, and theatres
Include non-specialized meeting, teaching, studying, and assembly space. - Cafeteria and food services
Space used for cooking, food preparation, and refrigeration space.
e.g., fast food restaurant, residence cafeteria - Retail
Space designated to the sale of food and non-food goods requiring little to no cooking, refrigeration, or food preparation.
e.g., convenience store, book store, grocery store - Laboratory
Specialized instruction or research space that is not suitable for general use.
i.e., caters to a specific program or group - Library
Space used to store and manage collections of literary and artistic materials (e.g., books, periodicals, newspapers, films) that can be used for reference or lending.
Include library study areas. - Office space
Administrative office space.
e.g., professor's offices, admin offices, student group offices, computer server rooms - Athletics facilities
All indoor athletic and recreational space.
e.g., ice rinks, gyms, weight training, curling rinks, pools - Warehouse
General storage space.
Include refrigerated and non-refrigerated warehouse space. - Residences
Student living accommodations.
Include sanitary amenities such as showers, washrooms, and laundry facilities. - Stadium
Include both outdoor open-air and closed stadium. - Repair shops and manufacturing
Technical area where repair, assembly, or fabrication occurs. - Other
Include non-specific shared spaces.
e.g., atriums, foyers
Specify other activity or function 1:
Specify other activity or function 2:
Specify other activity or function 3:
Specify other activity or function 4:
Specify other activity or function 5:
Specify other activity or function 6:
23. On December 31st, 2019, what was the percentage of floor space used for the following activities or functions at this campus?
Provide your best estimate rounded to the nearest percentage.
a: Classrooms, conference rooms, and theatres
Include non-specialized meeting, teaching, studying, and assembly space.
Percentage of floor space:
b: Cafeteria and food services
Space used for cooking, food preparation, and refrigeration space.
e.g., fast food restaurant, residence cafeteria
Percentage of floor space:
c: Retail
Space designated to the sale of food and non-food goods requiring little to no cooking, refrigeration, or food preparation.
e.g., convenience store, book store, grocery store
Percentage of floor space:
d: Laboratory
Specialized instruction or research space that is not suitable for general use.
i.e., caters to a specific program or group
Percentage of floor space:
e: Library
Space used to store and manage collections of literary and artistic materials (e.g., books, periodicals, newspapers, films) that can be used for reference or lending.
Include library study areas.
Percentage of floor space:
f: Office space
Administrative office space.
e.g., professor's offices, admin offices, student group offices, computer server rooms
Percentage of floor space:
g: Athletics facilities
All indoor athletic and recreational space.
e.g., ice rinks, gyms, weight training, curling rinks, pools
Percentage of floor space:
h: Warehouse
General storage space.
Include refrigerated and non-refrigerated warehouse space.
Percentage of floor space:
i: Residences
Student living accommodations.
Include sanitary amenities such as showers, washrooms, and laundry facilities.
Percentage of floor space:
j: Stadium
Include both outdoor open-air and closed stadium.
Percentage of floor space:
k: Repair shops and manufacturing
Technical area where repair, assembly, or fabrication occurs.
Percentage of floor space:
l: Other activity or function 1
Percentage of floor space:
m: Other activity or function 2
Percentage of floor space:
n: Other activity or function 3
Percentage of floor space:
o: Other activity or function 4
Percentage of floor space:
p: Other activity or function 5
Percentage of floor space:
q: Other activity or function 6
Percentage of floor space:
Total of floor space
Contact person
Note: In the future, a questionnaire will be sent with questions on campus characteristics, energy consumption and usage, campus modifications, and campus type specific questions.
The designated contact person should be the person who is best suited to answer this questionnaire. This person would be someone who is knowledgeable about the energy consumption and usage of this campus.
i.e., someone who has access to energy bills and knowledge about the structure and details of this campus (e.g., property manager, building manager, facilities manager, building owner).
24. Is the contact person the best person to fill out the survey?
- Yes
- No
Who is the best person to fill out the survey?
Company or Organization:
First name:
Last name:
Title:
Preferred language:
- English
- French
Email address:
Example: user@example.gov.ca
Telephone number (including area code):
Example: 123-123-1234
Extension number (if applicable):
Mailing address (number and street):
City:
Province, territory or state:
- 1: Alberta
- 2: British Columbia
- 3: Manitoba
- 4: New Brunswick
- 5: Newfoundland and Labrador
- 6: Northwest Territories
- 7: Nova Scotia
- 8: Nunavut
- 9: Ontario
- 10: Prince Edward Island
- 11: Quebec
- 12: Saskatchewan
- 13: Yukon
- 14: Alabama
- 15: Alaska
- 16: American Samoa
- 17: Arizona
- 18: Arkansas
- 19: California
- 20: Colorado
- 21: Connecticut
- 22: Delaware
- 23: District of Columbia
- 24: Federated States of Micronesia
- 25: Florida
- 26: Georgia
- 27: Guam
- 28: Hawaii
- 29: Idaho
- 30: Illinois
- 31: Indiana
- 32: Iowa
- 33: Kansas
- 34: Kentucky
- 35: Louisiana
- 36: Maine
- 37: Marshall Islands
- 38: Maryland
- 39: Massachusetts
- 40: Michigan
- 41: Minnesota
- 42: Mississippi
- 43: Missouri
- 44: Montana
- 45: Nebraska
- 46: Nevada
- 47: New Hampshire
- 48: New Jersey
- 49: New Mexico
- 50: New York
- 51: North Carolina
- 52: North Dakota
- 53: Northern Mariana Islands
- 54: Ohio
- 55: Oklahoma
- 56: Oregon
- 57: Palau
- 58: Pennsylvania
- 59: Puerto Rico
- 60: Rhode Island
- 61: South Carolina
- 62: South Dakota
- 63: Tennessee
- 64: Texas
- 65: U.S. Minor Outlying Islands
- 66: Utah
- 67: Vermont
- 68: Virgin Islands of the U.S.
- 69: Virginia
- 70: Washington
- 71: West Virginia
- 72: Wisconsin
- 73: Wyoming
Postal code or ZIP code:
Example: A9A 9A9 or 12345-1234
Country:
- Canada
- United States
- Other