Questionnaire Poison Plants

SECTION A -- How/Why/What can you contribute?

1. How did you come to this page?
   
   
   
   
2. Why were you looking for this page?
   
   CuriosityPoisoned CAT?Dog? Human?To check its reliability.
   
   
3. Comments please on the contents of the Poison Plant list, e.g. mistakes in or more information on names, toxic substances, description of symptoms, description of FIRST AID:
   
   
   
   
4. I would like to be able to reach you in case of need:

   Name:          
   URL:           
   Email Address:  
   City/Town      
   Country         

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Section B -- Do you like this questionnaire and the List?

1. How do you like this questionnaire?
   
   Not at allIndifferent Like itLove itDon't appreciate intrusion of privacy
   
   
2. How do you like the List?
   

   Not at allIndifferent Like itLove itDon't appreciate intrusion of privacy
   

3. Name subjects in which you're interested:
   
   Cats in particular
   Pets in general
   Biology in general
   Botany in particular
   Other subjects, please list them:
   
   
   
   
   

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Section C -- Catpurrsonal information

1. Which Cats do you prefer?

   Siamese     Mandarins    Maine Coons     Common House
   Oriental Shorts    Abyssinians     Norwegian Forest Cats   
   Turkish Van
   Balinese Somalis     Persians     Others
   

2. Comments please:
   
   
   
   

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Sending of Form

Thank you very much for filling out and submitting this form.

I will only use the data in this form to complete the Poison Plant list, and -eventually- to correspond with you about your comments.

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