|
Hello: You are invited to participate in our Pyroluria survey. It will take about 5 minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below. |
| |
|
|
|
Do you have little or no dream recall? |
| |
|
|
|
|
Do you have white spots on finger nails |
| |
|
|
|
|
Do you have poor morning appetite? |
| |
|
|
|
|
Experience Depression, anxiety or mood disorders? |
| |
|
|
|
|
Feel tired and fatigued a majority of the time? |
| |
|
|
|
|
Pale skin +/- poor tanning +/- burn easy in sun |
| |
|
|
|
|
Sensitivity to bright light? |
| |
|
|
|
|
Hypersensitive to loud noises? |
| |
|
|
|
|
Reading difficulties (e.g. dyslexia)? |
| |
|
|
|
|
Poor ability to cope with stress? |
| |
|
|
|