What is your test code? (marked on the box)
What is your email address?
What is your Gender?
How old are you?
Please confirm that you did not have menstruation at the time of taking the test?
Do you use any form of contraceptives right now?
Are you pregnant?
Have you used any antimicrobial treatment in the past month?
Do you have any of the following (only fill out if you have any of these symptoms)?
