So much has been kept from both the public and scientific communities for so long that we are just beginning to understand what went on in regards to the removal of the SV40 virus from the Sabin (OPV) vaccine.
If you know anything about the connection between SV40 and the Oral Polio Vaccine (OPV) or if you or someone you love might have been affected by SV40 and the Oral Polio Vaccine, please fill out this questionnaire to the best of your abilities and help us discover the truth.
YOUR INFORMATION
Last Name:
Address:
Phone:
Fax:
Email:
INFORMATION OF PERSON POTENTIALLY AFFECTED BY SV40
(If different from above information)
First Name:
Last Name:
Address:
Phone:
Fax:
Email:
VACCINATION INFORMATION FOR THE POLIO VACCINE
1st Dose
2nd Dose
3rd Dose
4th Dose
Date Administered:
Type Administered:
Lot Manufacturer:
Lot ID Number:
ADDITIONAL INFORMATION
If you have any additional information you feel might be helpful in our Search for the Truth, please enter it below.
