H1N1 Survey

Please complete the following survey if you, your significant other or your child(ren) has had the H1N1 illness (either confirmed or suspected). The results will be compiled for a future blog post and are for informational purposes only.

IMPORTANT: Please fill out a NEW survey for EACH person who had H1N1.

Thank you so much for your participation. Please feel free to pass this on to anyone you know who has had H1N1.

Warmly,
Amy
http://crunchydomesticgoddess.com

Disclaimer: This survey should not be used in place of medical advice. If you think you or someone you know has H1N1, please call your doctor.

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Very mild Near death