Participant' Questionnaire for GFGF Pesticides-Checkup

Good Food Good Farming and EXPOZOM thank you for your participation in the Pesticide-CheckUp project, a european-wide campaign to measure pesticide exposure in citizens’ hair.

The results are dependent on the quality of the hair sample. To collect your hair sample, please follow the instructions given in the user guide.

Please keep the user guide in a safe place after having conducted the test; the unique ID on the last page is necessary to get your individual results.

The information provided on this sampling form is essential to interpret the results. It is very important to complete this form with accurate information and send it with your sample.

“The personal data you provide will be used exclusively for the purpose of the report statistics. All data will be anonymised. Your personal data will be processed in accordance with the EU General Data Protection Regulation.“

An electronic sampling form is available at for automatized treatment.