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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?
 
Yes
 
No
 
 
 
Do you have white spots on finger nails
 
Yes
 
No
 
 
 
Do you have poor morning appetite?
 
Yes
 
No
 
 
 
Experience Depression, anxiety or mood disorders?
 
Yes
 
No
 
 
 
Feel tired and fatigued a majority of the time?
 
Yes
 
No
 
 
 
Pale skin +/- poor tanning +/- burn easy in sun
 
Yes
 
No
 
 
 
Sensitivity to bright light?
 
Yes
 
No
 
 
 
Hypersensitive to loud noises?
 
Yes
 
No
 
 
 
Reading difficulties (e.g. dyslexia)?
 
Yes
 
No
 
 
 
Poor ability to cope with stress?
 
Yes
 
No
 
If you have answered yes to 4 or more in this brief questionnaire, then consider further testing.
Please call 404-477-1797 for more information.
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