Citizen's Petition Sign-up Form

Women’s Voices for the Earth and the Environmental Working Group are filing a petition with the Food and Drug Administration (FDA) asking the agency to take action on the use of formaldehyde in hair straighteners. We need salon workers whose health has been impacted by these products to sign on to the citizen's petition. Please fill out the form below to sign on. Once the petition is drafted we will send you a copy of the citizen's petition to review. Please contact Jamie if you have any questions: jamiem@womensvoices.org

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* 1. Please enter your contact information 

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* 2. Do you suspect your health has been impacted by the use of hair straighteners that contain formaldehyde?

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* 3. Do you recall the name of the hair straightening brand?

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* 4. What kind of health effects have you experienced that you have reason to believe are a result of exposure to hair straighteners?

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* 5. Would you be willing to share your story with the media as a way to raise awareness about this issue?

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