Information about the Unseen EnvironmentKeeping Sedona Aware of Electrosmog
Home
ELECTROSMOG
SMART METERS
COMMUNICATION TOWERS
HYATT CACTUS VS MICROWAVES
EUROPEAN STANDARDS BASED ON BIOLOGY
SENSLESS US EXPOSURE STANDARDS
ACTUAL SEDONA MEASUREMENTS
HEALTH EFFECTS
CELL PHONES CAUSE CANCER
Consensus and Controversy
MICROWAVE EFFECTS ON BLOOD
CAN SMART METERS MAKE YOU SICK?
CALIFORNIA DEATHS AFTER SMART METERS
MALFUNCTIONS
SURVEYS
HEALTH RECORDS
DAILY SYMPTOM REPORT
MALFUNCTION REPORT
INFO & CONTACT
CONTACT US
INFORMATION LINKS
OTHER ENVIRONMENTAL TOXINS
New Page
This health Survey is based on symptoms from the Austrian Medical Society electro-hypersensitivity syndrome (EHS) questionnaire. Additional common complaints from Sedona residents have been added.
Information will be held confidential and only statistics summarized.
Please create a unique ID so you may return and update data. The ID can be a made-up name, numbers, or combination so that your data will be anonymous.
Email (optional)
*
*
Indicates required field
Please create an ID so you can update data
*
Choose One
*
Male
Female
What is your age?
*
Less than 20
21-30
31-40
41-50
51-60
61-70
71-80
more than 81 (congratulations!)
AUSTRIAN MEDICAL SOCIETY AND OTHER SYMPTOMS
*
Anxiety
Brain Fog
Chest tightness
Depression
Dizziness
Ear Pressure sensation
Fatigue
Headaches
Head Pressure
Irritability
Memory, short term loss
Opthalmic migraine
Seizures
Sleep Disturbance
Words, difficulty finding
None of the above
Neurological/Emotional: Choose as many as have increased in the last year.
OTHER SUBJECTIVE SYMPTOMS
*
Chronic Fatigue
Falls
Overwhelmed sensation
Rapid aging
Lack of ambition
None
PHYSICAL SYMPTOMS, CHOOSE ALL THAT APPLY
*
Allergies increased
Arthritis, increase
Blood pressure, high
Blood pressure, low
Blood sugar problems
Chest tightness
Eyes, burning sensation
Eyes, difficulty focusing
Change in glasses prescription (LARGE)
Headaches
Head Pressure
Heart Palipitations
Muscle cramps
Muscle loss (sarcopenia)
Muscle soreness
Muscle weakness
Night sweats
Numbness, neuropathy
Skin Rashes
None of the above
Physical symptoms: Choose as many as have INCREASED since April 2014
RECENT DIAGNOSES AND EVENTS
*
Alzheimer's
Cancer
Diabetes
Stroke
Kidney Disease
Parkinson's
Death (any cause)
None of the above
Other:
*
Other:
*
Comments and recent diagnoses:
*
Comments and recent diagnoses:
*
Submit