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* 1. Age

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* 2. Please select the region where you live

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* 3. How many times (to your knowledge) have you been bitten by a tick?

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* 4. How did you remove the tick which bit you? Please select multiple boxes if they apply to you.

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* 5. Please select your occupation from the list bellow

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* 6. Did you have a Bull's Eye rash?

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* 7. Please select the various options which apply to you.

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* 8. Have you got ongoing symptoms after treatment

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* 9. If you have Lyme disease, how long did it take you to be diagnosed? And how long have you been on treatment for?

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* 10. Please share any other comments you have below:

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