Thank you for completing this survey. I would like to send you a free thank you gift as a token of my appreciation.
If you would like me to send you a free gift, please make sure that your mailing address is included above.
Please chose from the items below. And then submit this survey.
Please fill out this survey to the best of your knowledge.
Approximate dates are acceptable if the exact date is not known.
1. Date that MS symptoms Started
6. If yes to #4, did you monitor mercury levels with any mercury analysis tests before, during or after mercury detox?
8. Did you take any MS treatment drugs prior to Mercury removal?
3. Date last mercury filling was removed.
4. Did you do a mercury/heavy metal detox or chelation after mercury removal?
2. Date MS was diagnosed, and what was used to make diagnoses (ie. MRI, LP, etc.)
7. If yes to #6, what tests were used, and what were the mercury levels at what point in the detox.
5. If YES to #4, For how long did you do mercury detox.
*required field
This survey is for anyone who has been diagnosed with Multiple Sclerosis who has ever had Mercury/Amalgam fillings and no longer has them, no matter the reason or method of removal.
Thank you for participating in this survey to help me to find out if removing mercury fillings has really been beneficial in the treatment of MS or not.
Your personal information is kept confidential. We NEVER sell or distribute your personal information.
If you include your address, I will send you a small thank you gift for participating in this survey.
Your survey answers will be kept confidential. Any results of this survey that are made available to the public will not have any of your personal information attached.
I will not share your specific case, not even with your name withheld, unless you give your express permission. If you want to share your experience in your own words, there is a space provided at the end of the survey where you can write anything that you consent to allow me to share with others and publish on my website(s). THANK YOU!
23. Feel free to share your experience in your own words in the following box.
I will only share your experience with others, or quote it on my websites if you click "yes", you give me permission to share your experience.
Please write it exactly as you would like it to appear quoted if your story is chosen to be shared with others. This is the only part of the survey that will be shared or published on my website, so feel free to include any information listed above if you want it to be part of your story that you want me to share with others. You may include your name, or just your initials, where you are from, however you want it to appear with your story.
