Survey

Name(Required)
I am filling this survey out for
If you are the parent or guardian of a study participant who is under 18 years of age and whose data you are providing in this survey, please enter your name
Address(Required)

About You

Biological Gender(Required)
Education level(Required)
Sample Type(Required)

Your Surroundings

How would you characterise where you live?(Required)
Do you live near a farm(Required)
Do you live near a golf course, vineyard, park?(Required)

Your Activity

Have you visited a non-organic farm in the last 30 days?(Required)
Do you work outdoors(Required)
Do you play golf?(Required)
Do you play any sports where you make contact with grass? eg Football, soccer(Required)
Do you visit local or state parks(Required)
Do you use Round-up or other herbicides (weedkillers) at home or at work?(Required)
If you use Round-up, do you use protective gear?(Required)
Do you have a lawn care service spray your lawn?(Required)
Do your neighbours use Round Up?(Required)

Your Diet

Do you consume fresh juices or smoothies?(Required)
Do you consume beer or wine?(Required)
Do you consume non-organic whole wheat products (i.e. bread, crackers, shredded wheat, wheat bran, or whole wheat flour)?(Required)
How often do you consume other non-organic legumes (i.e. beans, peas, lentils, chick peas, hummus)?(Required)
Do you consume non-organic oats (ie oatmeal, in cookies, muffins or as oat flour)??(Required)
What percentage of your diet would you estimate is organic?(Required)
How many meals do you eat outside of home per week?(Required)
What type of diet do you maintain?(Required)
Do you have any dietary exclusions?
Is most of the water you consume(Required)

Your Health

How would you describe your overall health
Are you suffering from any of these health problems?
Consent(Required)