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* 1. Do you know if you currently have a "smart" meter or radio frequency emitting device on your home/apartment?

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* 2. If you do have one, do you know when it was installed?

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* 3. Did you have a negative health response immediately when the RF emitting "smart" meter was installed?

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* 4. Have you tried to get the power company or anyone to remove it?

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* 5. Were you successful in removing it?

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* 6. Are you currently having health problems?

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* 7. Would you associate any of your health problems with the presence of the RF emitting "smart" meter(s)?

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* 8. Describe the symptoms or health problems you have experienced since the installation of the RF "smart" meter.

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* 9. Did you know that "smart" meters are surveillance devices for collecting your personal usage and behavioral data to be sold for profit by your electric company to corporations (and made permanently available to police, state and federal agencies) wanting your personal inside-home information?

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* 10. Will you financially support or participate in a movement to have local legislation passed in NC (as other states have successfully done) to ensure an opt-out to RF meters? (see http://raleighes.info/Support/Funds.html)

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