Here's the draft form. Before anyone fills it out, willing to entertain comments on any additional info to add. This is the list of questions that Michael and I narrowed it down to. You can request a copy of your responses (at the bottom of the form) and you should be able to edit your responses later.
docs.google.com
The responses will be automatically dumped into a worksheet that I'll forward to Michael after some period of time. There's no way around entering your email address and name, that I can think of, as Michael will need that to match against his list. But I won't expose the responses on here. You're welcome to try to find the response worksheet if you want to test Google's security, but I have not permitted it to anyone (i.e., it's private).
Just doing this to help resolve the situation. I don't have a horse in this race as I picked up my cells from on-hand stock months ago.