This form is solely to register your health experience(s) after being at Standing Rock, ND. It is not connected to any governmental agency; it is a grassroots approach. The survey results will be available to you for you to talk with your doctor(s) but is in no way providing medical advice here now. The survey results will not be used for any other purpose(s). This confidential effort is strictly to register your health experience(s) after visiting Standing Rock, good or bad. There are many stories about the Dakota Access Pipeline (DAPL) personnel spraying/dusting an unknown aerial substance over camps at night and people becoming ill. Hopefully with your input we can eliminate the rumor(s) and establish health facts that will allow people to make decisions and get proper care.