1.
Do you have biting, itching, and or crawling
sensations on your skin but can’t see what is causing it?
2.
Have you seen a dermatologist or doctor for it but
believe you have been misdiagnosed?
3.
Are you unable to sleep thru the night due to the symptoms?
4.
Is there a particular time of day that your
symptoms worsen?
5.
Does sweating aggravate your symptoms?
6.
Are you male or female?
7.
What is your age?
8.
In what area of Maui do you live?
9.
How long have you had these symptoms?
10.
Do you have any pets?
11.
Before the symptoms occurred how would
you rate your overall health?
12.
Do any other household members have the
same or similar symptoms?
13.
Did treating your environment with pesticides
or bombs fail?
14.
Do you have any symptoms affecting the
skin on your face?
15.
Are the symptoms in the folds of the skin or on
larger surfaces like back or outer arms etc?
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