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Purpose of Survey

Thank you for taking the time to complete this survey conducted by the Karl McManus Foundation. Your participation is crucial to advancing research and understanding of tick-borne illnesses that will save lives in Australia.

We are committed to protecting your privacy. All information you provide is handled with strict confidentiality and stored securely in compliance with relevant medical data protection regulations. You can be confident that your data is treated with the highest standards of care and security.

Full Name

Email Address*

Approval

I approve and request a PDF with tips/recommendations/contacts to be emailed to me

I approve a follow-up email in 6 weeks

I approve the storage of my survey information for research purposes *

Select Age *

Mobile number

Gender *

Residential Address

Suburb

Post Code

Details of the address/location at which you suffered the tick bite. (Complete only sections with details known to you).

Street Number/Name *

Suburb*

Post Code*

Describe the terrain - beach, mountain, river, bush*

Where do you think the tick came from? Bush, pets, horses*

Date of tick bite - Estimated if unknown *

When did you first notice the tick/bite? *

Bite Details

What is the location of the tick bite on the body?*

Please state initial symptoms immediately after being bitten*

Please state any current symptoms after being bitten*

Tick (Insect) Identification

Do you have a bull’s-eye rash? Bull’s-eye rash example A bull’s-eye rash is a circular rash that may appear after a tick bite and often expands outward from the bite site.

Pictures of Bite/Insects/Symptoms/site of bite

If you have extracted the tick, what was the method of extraction?

Did you seek professional help removing or treating the tick bite?

Have you been bitten previously?

Yes

If so, what was the site of the previous bite?

When did you last get bitten?

What were the symptoms from the last bite?

Did you go on any previous treatments for the bite?

Do you have any known medical conditions?

Have you consulted a healthcare professional?

Did your doctor do any laboratory test for Tick Borne Illness?

Response

What was your initial treatment response?

You're almost done — thank you!

Please tick the box for others to fill the survey if others were bitten at the same time as you

Would you like to share this survey link with others?

We sincerely appreciate the time and effort you’ve taken to complete this survey, your participation truly helps save lives. Your input is invaluable in helping us better understand tick-borne illness and improve outcomes for those affected.

Please review your responses if needed. When you're ready, click Submit to securely send your answers to the research team at the Karl McManus Foundation.

Together, we can drive change through research and awareness. Thank you again for being part of this crucial work.

Australian Tick Bite Survey