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30th October, 2011
Dear Sir/Madam,
First of all, thank you for your consideration to fill in this questionnaire. I appreciate it a very much.
I am a student in my final year at high school. I am doing my personal project this year, and I am doing it on the topic: the influence a food allergy has on the quality of life. I am doing this project under the subject of biology.
This project has the goal of researching how a food allergy influences the patient socially, the difference in how male and female patients deal with their allergy, how age influences the way an patients faces their food allergy and how the different impact a food allergy has on quality of life versus several food allergies.
I would like to let you know that participation in this survey is completely voluntary. Therefore any question which you feel uncomfortable or unable to answer, please don’t hesitate to leave it open. Secondly, this questionnaire is completely anonymous. Any information you provide will be used only for this project.
It will take about 15 minutes to answer the questionnaire that is enclosed. Your answers to this questionnaire will help me in finishing my project and research. I will use your answers only for my project, and this shall only been seen by me and my assessor.
Thank you for your time and willingness to fill in this survey and help me with my project.
Sincerely,
Pomme Simons
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| How many foods (e.g. peanuts, milk, shellfish etc.) are you allergic to? |
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| What type of foods are you allergic to? |
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| Who diagnosed you with a food allergy? |
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| Do you have any other chronical illness? |
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| Have you ever experienced an allergic reaction? |
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| What symptoms did you have when you had a reaction? |
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| How annoying do you find it that
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