On what day did you get sick? - -Jan.Feb.MarchAprilMayJuneJulyAug.Sept.Oct.Nov.Dec. - -12345678910111213141516171819202122232425262728293031 - -201020112012 Time of day: MorningAfternoonEvening Beach is in or close to: County: MonmouthOceanAtlanticCape May Town: AllenhurstAsbury ParkAtlantic CityAvalonAvon-by-the-SeaBarnegat Lighthouse State ParkBay HeadBeach HavenBeach Haven CrestBeach Haven GardensBeach Haven HeightsBeach Haven ParkBeach Haven TerraceBelmarBradley BeachBrant BeachBrielleBrigantineCape MayChadwickCorson's Inlet State ParkDealHarvey CedarsHolgateIsland Beach State ParkLavalletteLong BranchLongportLoveladiesMansquanMantalokingMargate CityMonmouth BeachN. WildwoodNormandy BeachNorth Beach HavenOcean BeachOcean CityOcean GroveOrtley BeachPoint PleasantPoint Pleasant BeachSandy HookSea BrightSea GirtSea Isle CitySeaside HeightsSeaside ParkShip BottomSouth Mantoloking BeachSouth Seaside ParkSpray BeachSpring LakeStone HarborStrathmereSurf CityTownsends InletVentor CityWildwoodWildwood Crest Street or break name: Your Name (required) Your Age Your Email (required) Phone Number What were your symptoms? NauseaEye InfectionEar InfectionSinus InfectionSkin InfectionOther Additional Description: How long after you were in the ocean did your illness symptoms start? ImmediatelyWithin the DayNext DayAfter 2 DaysAfter 3 DaysWithin the WeekOther How long did your illness last? 1-3 Days1 Week2 Weeks3 Weeks1 MonthMore than 1 MonthCurrently Sick Did you see a doctor? YesNo Physician's Name: If treated, what was the diagnosis and treatment? How many times have you been sick from the ocean at the beach you listed above? 123More than 3 Add any other comments you may have: I agree By checking here you agree to the Terms and Conditions.