The following survey is for research purposes only and is meant to gather data on exposure symptoms related to the February 3, 2023 train derailment. This data is being collected by East Palestine, Ohio resident Ashley McCollum and may potentially be shared with researchers and scientists who are studying the aftermath of the train derailment.
NO PERSONAL IDENTIFYING INFORMATION WILL BE TIED TO YOUR SURVEY RESULTS WHEN SHARED.
If any updates are made to this survey, you may be asked to fill it out again.
Fields marked as required must be filled out, otherwise all other fields are optional.
Uploading photos may take a few minutes after you click Submit. If you wish to send photos to Ashley directly, you can email her at ashleymccollum@activist.com.
If you have any issues with filling out the survey, feel free to reach out to Ashley for assistance at ashleymccollum@activist.com.