What is your gender?’

 
 

What is your age group?

 
 
 

What is your ethnic origin based on the majority of your ancestors

 
 

When you went out in the sun without sunscreen, did you burn easily and never tan, (or only tan a little bit)?

 
 

Since you were born, how many times have you been so severely sunburnt that you peeled and blistered?

 
 
 

As a teenager, how many moles and/or freckles did you have?

 
 
 

Has anyone in your immediate family had a melanoma? (This is the most dangerous skin cancer and is always treated by cutting it out)

 
 

Have you had sunspots burnt or frozen off?

 
 
 

Have you had any type of skin cancer cut out?

 
 
 

Were any of the skin cancers in question 9 a Melanoma?

 
 

Question 1 of 10

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