melisa

MELISA Survey

Your Experience with Metal Sensitivity

MELISA Diagnostics aims to help increase awareness about metal hypersensitivity and educate health practitioners, as well as the public, on how metals can have adverse effects on hypersensitive patients. By submitting your information, you can help increase our understanding of the issue and potentially guide others. Please note that you should only fill out the survey if you have had some sort of metal hypersensitivity test.

A patient testimonial or a case study could be compiled to share your story with others, and you can remain anonymous.

Thank you for taking the time to share your experience!

Your Name (optional)

Please let us know your name.

Your Email(*)

Please let us know your email address.

1. What were your sources of metal exposure before taking a metal hypersensitivity/MELISA test?(*)

Dental exposure
Orthopedic implant - Pins, plates, screws
Orthopedic implant - Hip/knee/shoulder replacement
Orthopedic implant - Spinal implant

Staples, clips, coils
Cardiac implants
Environmental or occupational exposure
Other

Invalid Input

If "Other", please specify

Invalid Input

2. Which metals/alloys you were exposed to?(*)

Amalgam
Non-noble alloys for dental restorations
Noble alloys for dental restorations
Stainless Steel
Cobalt-Chromium alloy

Pure Titanium
Titanium alloy
Tantalum
Zirconium or Zirconia
Unsure

Invalid Input

3. Which symptoms did you experience?(*)

Contact dermatitis
Muscle or joint pain
Inflammation
Brain fog

Fatigue
Headaches
Depressin
Other

Invalid Input

Please give more details if you wish

Invalid Input

4. Was a treatment plan developed based on the results? What kind of treatment did follow?(*)

My exposure was completely removed
My exposure was partially removed
I had a revision surgery
Further treatment should follow

Currently, it is not possible to remove or replace the exposure
A treatment plan has not yet been established following the results
Other

Invalid Input

Please give more details if you wish

Invalid Input

5. In case you proceeded with treatment, please provide more details on the outcome:

My symptoms have greatly improved or disappeared
There is a noticeable improvement in my symptoms
There is some improvement in symptoms

There is no significant improvement in my symptoms
Other

Invalid Input

Please share any details which you find relevant to your experience

Invalid Input

how we can process the provided information?(*)

I am willing to share my story and compile a case study or testimonial; you can reach out to me with more questions by email
I am willing to share my story and compile a case study or testimonial; please call me for more details
You can use the data for your statistics, but I am not willing to share my story publicly Invalid Input

If you wish us to call you, please provide your phone number

Invalid Input

I consent to my information being used accoring to our Privacy Policy(*)

Yes Invalid Input

Type correct letters here(*)

Invalid Input

MELISA® is a blood test to aid the diagnosis of metal hypersensitivity. It is used worldwide by healthcare professionals to help determine whether patients are hypersensitive to metals commonly used in dental restorations or medical implants.

Contact UK and worldwide

+44 20 8178 9656
This email address is being protected from spambots. You need JavaScript enabled to view it.

Contact USA

270-429-7151
This email address is being protected from spambots. You need JavaScript enabled to view it.

Terms & Conditionsl Privacy policy