Fluoride testimonial

This form is designed to collect data for a Fluoride Testimonials page – a database of adverse health effects possibly caused by fluoride or fluoridation chemicals in Australia.

Before completing this form, please note the following:

  1. Your full name and e-mail address will NOT be published
  2. Your initials, age and post code WILL be published, for example: JC/48/2350
  3. All other data provided may be published