We recognize that this form is quite lengthy. Please be aware that sections may be skipped that do not apply if a required question is not present.
The LRCA Health Committee is the author of this form and reserves all copyrights and moral rights due to an author worldwide. By completing this form, you agree that copying any of any portion of the survey material, survey questions, and data is prohibited. Requests for consent for usage of portions of the survey or for survey data may be sent to: Health@lagottous.com *