20 – 25 questions survey for the world trade center pre healthcare workers

i need a 20-25 question survey for the healthcare responders ie, firefighters , EMS and volunteers that responded to the world trade center. the survey should include the following :

– personal information section ( age, ethnicity, employer , contact info . etc )

– time spent at the cite of the disaster , location , exposure to the dust , etc ..

– physical assessment, any diseases related to the dust inhalation, what measures taken to protect them , did it work etc ..

– medical history of respiratory disorders

– any other questions that you might find related to the research will bee helpful

i will attach the research proposal when you accept the assigment, it might give you some guidance in the survey