Study on Social Media & Chronic Conditions: Preliminary Questionnaire

 
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1. What is your first name?
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2. What is your last name?
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3. What's your email address?
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4. How old are you?
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5. In what city/state do you live? For example: Queens, NY
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6. Do you have any of the following chronic health conditions?
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7. How old were you when first diagnosed?
8. How did you hear about this study?
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