What is your living status?*

Are you responding on behalf of a child? *

How many people live in your household?

How many people in your household have been impacted by mould-related illness?

Which of the following best describes your situation? *

Which of the following symptoms have you experienced as a result of mould exposure / what you suspect is mould exposure? Please tick all that apply:*

How would you rate your symptoms, generally? *

Which of the following mental health symptoms, if any, have you felt as a result of mould-related illness? Pleased tick all that apply: *

How long have you had symptoms of mould-illness? (If you have recovered, please also tick the last box): *

Which of the following best describes your situation?*

What was the cause of mould growth / contamination in your property / workplace etc? *

Which of the following types of NHS practitioners have you consulted, or has someone consulted on your behalf? Please tick all that apply: *

Which of the following types of private practitioners have you consulted, or has someone consulted on your behalf? Please tick all that apply: *

Which type of practitioners assisted in accelerating your journey to diagnosis and treatment of a mould-related illness? Please tick all that apply. *

Of the following type of consultants, which, if any, have acknowledged that mould could be the cause of your symptoms *

Has environmental testing confirmed that mould spore counts are indexing high in your home? *

Which of the following environmental testing methods have you used to detect mould? Please tick all that apply:*

How much have you spent, to date, on environmental testing?*

Which of the following health diagnostic tests have you had via the NHS? Please tick all that apply: *

Which of the following health diagnostic tests have you had via the private practitioner / service? Please tick all that apply:*

Did you trust the results of the test(s)? *

How much money have you spent on the health side of investigating suspected mould illness in total? *

How much money have you spent, in total, on the remediation of properties as a results of mould illness? *

How much money do you estimate you have spent on mould-illness related supplements, medicines or air technologies (PCO / purifiers) to date? *

Did you feel they worked? *

Does your mould-related illness impact the type of work you can do?*

Has your mould-related illness reduced your ability to work?*

Have you lost or had to leave your job as a result of mould-related illness?*

Are you on means-tested benefits as a result of your mould-related illness? *

Are you on health-related benefits as a result of your mould-related illness?*

Have you spoken to your employer about mould-related illness? *

If you would like to speak to your employer about mould-related illness, but haven't, what is preventing that from happening? *

If you have spoken to your employer, did they accommodate your additional health needs (flexible working / change of environment, health safeguarding, etc)? *

If you are a student, has your education been affected?

If you are under 18, has mould-related illness prevented you from accessing mainstream education?

Which of the following lifestyle side effects have you experienced as a result of mould-related illness? Tick all that apply. *

Would you like mould-related illness to be recognised by the NHS? *

Have you been tested for the Human leukocyte antigen (HLA) gene? *

If you have used a photocatalytic oxidation (PCO) technology, have you experienced an easing or reduction in your mould illness symptoms? *

Would you wish to be considered as a case study? This would involve an interview to share your story with others. *