Camp Lejeune-Questionnaire

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Best time to contact you? Time7am-9am9am-12pm12pm-5pm5pm-7pm7pm-12am

Did you or a close family member lived at Camp Lejeune between August 1, 1953, and December 31, 1987? *YesNo

Are you filing this on behalf of yourself or a family member? *YesNoChoice 3

If a family member, are they deceased? *YesNoChoice 3

When did you/relative live at Camp Lejuene?

Did you/relative live at Camp Lejeune consecutively for a minimum of 30 days? *YesNoChoice 3

After living at Camp Lejeune, did you develop health problems from toxic water? *YesNoChoice 3

Have you been diagnosed with any of the following? *What State did you reside in when using BetMGMBreast cancerBladder cancerKidney cancerLiver cancerLeukemiaEsophageal cancerFemale infertilityHepatic steatosisLung cancerMiscarriageMultiple myelomaMyelodysplastic syndromesNeurobehavioral effectsNon-Hodgkin's lymphomaRenal toxicitySclerodermaAdult leukemiaAplastic anemia and other myelodysplastic syndromesParkinson's disease

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