Please fill out this questionnaire if you have eliminated carrageenan from your diet and noticed changes in your health. Your identity and personal information will be held in strict confidence and never made public.

For research purposes, the results are shared with the medical researchers who helped create this questionnaire, in order to better understand the degree and severity of carrageenan-related symptoms in the general public.

We ask that you include your contact information for verification purposes and so that we can contact you in case there are questions about your entry.

Name
Sharing your email is optional, but it enables us to contact you with questions.

We will never share, rent or sell your personal information or email address. Please provide your email address for follow-up and verification purposes. We will not be able to count your questionnaire if you do not enter your email address. If you do not have an email address, please provide a phone number or physical address.

1. Please check which condition applies to you after you eliminated carrageenan from your diet (check all that apply):
If you answered a. or b., please answer the additional questions below.
2. Please describe the gastrointestinal symptoms you experienced before eliminating carrageenan from your diet. (check all that apply)
4. How long were you on a carrageenan-free diet before you noticed the change?
5. Before your symptoms improved, how long have you suffered from gastrointestinal discomfort?

On a scale of 1-5, with 1 being “terrible” and 5 being “excellent”, how would you rate the following:

7. Your gastrointestinal health before eliminating carrageenan from your diet:
8. Your gastrointestinal health after eliminating carrageenan from your diet:
9. Your general health before eliminating carrageenan from your diet:
10. Your general health after eliminating carrageenan from your diet:
11. Your ability to enjoy activities away from home before eliminating carrageenan from your diet:
12. Your ability to enjoy activities away from home after eliminating carrageenan from your diet:
13. Your ability to work before eliminating carrageenan from your diet:
14. Your ability to work after eliminating carrageenan from your diet:
15. Your ability to exercise before eliminating carrageenan from your diet:
16. Your ability to exercise after eliminating carrageenan from your diet:
18. How successful have you been at eliminating carrageenan from your diet?
19. Do you plan to continue eliminating carrageenan from your diet?
20. Do you give Cornucopia permission to use your name and comment in our official comments to the National Organic Program (NOP) and National Organic Standards Board (NOSB)?
If you haven’t already, please fill out the Carrageenan Consumer Survey.
This field is for validation purposes and should be left unchanged.