Environmental ExposuresSurvey Results


YesNoUnanswered
Did the Patient's mother live near high-voltage power lines or electromagnetic fields during time of pregnancy?152430
Did the Patient's mother live in an agriculture region during pregnancy?452130
Did the Patient's mother live near a toxic or hazardous waste site during childhood?112470
Did the Patient's father live near a toxic or hazardous waste site during childhood?102480
Did the Patient's mother live near an airport during pregnancy?182400
Did the Patient's mother have any Chemical exposures from hobbies, work, or home?452130
Did either of the Patient's parents live near a factory growing up or at the time of conception of your child?282300
Did the Patient's mother live near a factory during your pregnancy?152430
Have either of the Patient's parents or grandparents been struck by lightning or electrocuted?152430
Have either of the Patient's parents lived near a toxic waste or medical waste incinerator?42540

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