PGP Participant Survey
|
Responses submitted 10/21/2011 18:36:58.
Show responses
|
Timestamp |
10/21/2011 18:36:58 |
Year of birth |
40-49 years |
Which statement best describes you? |
I am comfortable making my genome sequence data publicly available without prior review. |
Severe disease or rare genetic trait |
Yes |
Do you have a severe genetic disease or rare genetic trait? If so, you can add a description for your public profile. |
I was diagnosed with invasive lobular breast cancer at age 39. My mother was diagnosed with breast cancer at age 43, my aunt at age 48, and my maternal great-grandmother at 43. The four of us represent 50% of the women in our four generations. I was tested for the BRCA 1 and 2 mutations and the CDH1 mutation and did not have any of them. |
Disease/trait: Onset |
30-39 years of age |
Disease/trait: Rarity |
Uncommon |
Disease/trait: Severity |
Moderate severity disease |
Disease/trait: Relative enrollment |
No |
Disease/trait: Diagnosis |
Yes |
Disease/trait: Genetic confirmation |
No |
Disease/trait: Documentation |
Yes |
Disease/trait: Documentation description |
There are mammogram images and pathology results that could be shared. |
Sex/Gender |
Female |
Race/ethnicity |
White |
Maternal grandmother: Country of origin |
United States |
Paternal grandmother: Country of origin |
United States |
Paternal grandfather: Country of origin |
United States |
Maternal grandfather: Country of origin |
United States |
Enrollment of relatives |
No |
Enrollment of older individuals |
No |
Enrollment of parents |
No |
Have you uploaded genetic data to your PGP participant profile? |
No, but I have genetic data and plan to upload it |
Have you used the PGP web interface to record a designated proxy? |
Yes |
Have you uploaded health record data using our Google Health or Microsoft Healthvault interfaces? |
Yes |
Uploaded health records: Update status |
Yes |
Uploaded health records: Extensiveness |
3 |
Blood sample |
Yes |
Saliva sample |
Yes |
Microbiome samples |
Yes |
Tissue samples from surgery |
Yes |
Tissue samples from autopsy |
Yes |
PGP Trait & Disease Survey 2012: Cancers
|
Responses submitted 11/8/2012 20:39:15.
Show responses
|
Timestamp |
11/8/2012 20:39:15 |
Have you ever been diagnosed with one of the following conditions? |
Breast cancer |
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 11/10/2012 8:15:42.
Show responses
|
Timestamp |
11/10/2012 8:15:42 |
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 11/10/2012 8:16:23.
Show responses
|
Timestamp |
11/10/2012 8:16:23 |
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 11/10/2012 8:16:58.
Show responses
|
Timestamp |
11/10/2012 8:16:58 |
Other condition not listed here? |
None |
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 11/10/2012 8:17:19.
Show responses
|
Timestamp |
11/10/2012 8:17:19 |
Other condition not listed here? |
None |
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 11/10/2012 8:17:49.
Show responses
|
Timestamp |
11/10/2012 8:17:49 |
Other condition not listed here? |
None |
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 11/10/2012 8:18:33.
Show responses
|
Timestamp |
11/10/2012 8:18:33 |
Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness), Dry eye syndrome |
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 11/10/2012 8:19:00.
Show responses
|
Timestamp |
11/10/2012 8:19:00 |
Have you ever been diagnosed with one of the following conditions? |
Hemorrhoids |
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 11/10/2012 8:19:20.
Show responses
|
Timestamp |
11/10/2012 8:19:20 |
Other condition not listed here? |
None |
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 11/10/2012 8:19:52.
Show responses
|
Timestamp |
11/10/2012 8:19:52 |
Have you ever been diagnosed with any of the following conditions? |
Dental cavities |
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 11/10/2012 8:20:36.
Show responses
|
Timestamp |
11/10/2012 8:20:36 |
Have you ever been diagnosed with any of the following conditions? |
Fibrocystic breast disease |
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 11/10/2012 8:21:17.
Show responses
|
Timestamp |
11/10/2012 8:21:17 |
Have you ever been diagnosed with any of the following conditions? |
Skin tags |
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 11/10/2012 8:21:55.
Show responses
|
Timestamp |
11/10/2012 8:21:55 |
Have you ever been diagnosed with any of the following conditions? |
Osteoarthritis, Sciatica, Scoliosis |
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 11/10/2012 8:22:28.
Show responses
|
Timestamp |
11/10/2012 8:22:28 |
Other condition not listed here? |
None |
PGP Basic Phenotypes Survey 2015
|
Responses submitted 1/5/2016 20:36:40.
Show responses
|
Timestamp |
1/5/2016 20:36:40 |
1.1 — Blood Type |
O + |
1.2 — Height |
5'10" |
2.1 — Left Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
14 |
2.2 — Right Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
14 |
2.3 — Left Eye Color - Text Description |
green with brown around iris |
2.4 — Right Eye Color - Text Description |
same |
2.5 —Comments |
My eyes were dark brown until puberty when they changed to green over less than a year. |
3.1 — What is your natural hair color currently, when without artificial color or dye? |
red |
3.2 — Hair Color - Text Description |
auburn |
3.3 — Comments |
My hair was much more red when I was younger, with more orange tones. It darkened during my twenties to a brownish red. |
1.4 — Handedness |
Right |
PGP Participant Survey
|
Responses submitted 8/3/2017 11:01:29.
Show responses
|
Timestamp |
8/3/2017 11:01:29 |
Year of birth |
1966 |
Do you have a severe genetic disease or rare genetic trait? If so, you can add a description for your public profile. |
My maternal great-grandmother, my mother, my maternal aunt, and I were all diagnosed with pre-menopausal breast cancer. My great-grandmother was 43, my mother was 43, my aunt was 48, and I was 39. My aunt had a recurrence again at age 70-something. I have been tested for about 17 different known mutations associated with breast cancer, but none have been identified. |
Sex/Gender |
Female |
Race/ethnicity |
White |
Maternal grandmother: Country of origin |
United States |
Paternal grandmother: Country of origin |
United States |
Paternal grandfather: Country of origin |
United States |
Maternal grandfather: Country of origin |
United States |
Month of birth |
August |
Anatomical sex at birth |
Female |
Maternal grandmother: Race/ethnicity |
White |
Maternal grandfather: Race/ethnicity |
White |
Paternal grandmother: Race/ethnicity |
White |
Paternal grandfather: Race/ethnicity |
White |
PGP Trait & Disease Survey 2012: Cancers
|
Responses submitted 8/3/2017 11:05:30.
Show responses
|
Timestamp |
8/3/2017 11:05:30 |
Have you ever been diagnosed with one of the following conditions? |
Breast cancer, Breast fibroadenoma |
Harvard PGP: COVID-19 Health Assessment for Week of 22-28 March 2020
|
Responses submitted 3/23/2020 19:28:42.
Show responses
|
Timestamp |
3/23/2020 19:28:42 |
Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Feeling cold, chills or shivers] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Headache] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Aches all over the body] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Cough] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Rapid breathing] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Shortness of breath] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Wheezing or chest tightness] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Bluish lips or face] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Dizziness] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Confusion or inability to arouse] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Running nose] |
Yes |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Sore throat] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Nausea] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Vomiting] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Abdominal pain] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Diarrhea] |
Yes |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of smell] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of taste] |
No |
Are you currently experiencing any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
Are you currently experiencing any of the following symptoms? [Feeling cold, chills or shivers] |
No |
Are you currently experiencing any of the following symptoms? [Headache] |
No |
Are you currently experiencing any of the following symptoms? [Aches all over the body] |
No |
Are you currently experiencing any of the following symptoms? [Cough] |
No |
Are you currently experiencing any of the following symptoms? [Rapid breathing] |
No |
Are you currently experiencing any of the following symptoms? [Shortness of breath] |
No |
Are you currently experiencing any of the following symptoms? [Wheezing or chest tightness] |
No |
Are you currently experiencing any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
Are you currently experiencing any of the following symptoms? [Bluish lips or face] |
No |
Are you currently experiencing any of the following symptoms? [Dizziness] |
No |
Are you currently experiencing any of the following symptoms? [Confusion or inability to arouse] |
No |
Are you currently experiencing any of the following symptoms? [Running nose] |
No |
Are you currently experiencing any of the following symptoms? [Sore throat] |
No |
Are you currently experiencing any of the following symptoms? [Nausea] |
No |
Are you currently experiencing any of the following symptoms? [Vomiting] |
No |
Are you currently experiencing any of the following symptoms? [Abdominal Pain] |
No |
Are you currently experiencing any of the following symptoms? [Diarrhea] |
No |
Are you currently experiencing any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
Are you currently experiencing any of the following symptoms? [Loss of sense of smell] |
No |
Are you currently experiencing any of the following symptoms? [Loss of sense of taste] |
No |
Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
Harvard PGP: COVID-19 Demographics Survey
|
Responses submitted 3/23/2020 19:30:57.
Show responses
|
Timestamp |
3/23/2020 19:30:57 |
What is the zip code of your primary residence? |
01460 |
Do have another residence where you spend more than 30 days a year? |
No |
What is your age (in years)? |
53 |
What is your gender? |
Female |
Select all the following that apply to your current living arrangements. |
Live with partner/spouse, college-age child (20 years old) |
What is your race? Pick all that apply. |
White |
What is your ethnicity? |
Not Hispanic or Latino or Spanish Origin |
Select which one of the following applies to you and your birth status. |
None of the above |
Have you ever been diagnosed with any of the following? [Asthma (Adult)] |
No |
Have you ever been diagnosed with any of the following? [Asthma (Childhood)] |
No |
Have you ever been diagnosed with any of the following? [Chronic obstructive pulmonary disease (COPD)] |
No |
Have you ever been diagnosed with any of the following? [Emphysema] |
No |
Have you ever been diagnosed with any of the following? [Chronic bronchitis] |
No |
Have you ever been diagnosed with any of the following? [Pneumonia] |
Yes |
Have you ever been diagnosed with any of the following? [Type 1 Diabetes] |
No |
Have you ever been diagnosed with any of the following? [Type 2 Diabetes] |
No |
Have you ever smoked tobacco products? |
No |
Have you ever used e-cigarettes (e.g. JUUL, Vuse, MarkTen)? |
No |
Which one of the following best describes your employment status for the past 3 months? |
Employed: Working 40 or more hrs per week |
Select the category that best describes your occupation. |
Educational Instruction and Library |
What is the zip code of your primary workplace/worksite? |
01460 |
Do you have a secondary workplace/worksite where you work more than 30 days a year? |
No |
If a vaccine against coronovirus (COVID-19) would reach the stage where it must be tested for safety and efficacy in humans, would you - assuming that you are eligible - be interested in taking part in that trial? |
Maybe |
Harvard PGP: COVID-19 Health Assessment for Week of 29 March- 4 April 2020
|
Responses submitted 3/30/2020 11:29:14.
Show responses
|
Timestamp |
3/30/2020 11:29:14 |
Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Feeling cold, chills or shivers] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Headache] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Aches all over the body] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Cough] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Rapid breathing] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Shortness of breath] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Wheezing or chest tightness] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Bluish lips or face] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Dizziness] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Confusion or inability to arouse] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Running nose] |
Yes |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Sore throat] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Nausea] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Vomiting] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Abdominal pain] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Diarrhea] |
Yes |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of smell] |
No |
Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of taste] |
No |
Are you currently experiencing any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
Are you currently experiencing any of the following symptoms? [Feeling cold, chills or shivers] |
No |
Are you currently experiencing any of the following symptoms? [Headache] |
No |
Are you currently experiencing any of the following symptoms? [Aches all over the body] |
No |
Are you currently experiencing any of the following symptoms? [Cough] |
No |
Are you currently experiencing any of the following symptoms? [Rapid breathing] |
No |
Are you currently experiencing any of the following symptoms? [Shortness of breath] |
No |
Are you currently experiencing any of the following symptoms? [Wheezing or chest tightness] |
No |
Are you currently experiencing any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
Are you currently experiencing any of the following symptoms? [Bluish lips or face] |
No |
Are you currently experiencing any of the following symptoms? [Dizziness] |
No |
Are you currently experiencing any of the following symptoms? [Confusion or inability to arouse] |
No |
Are you currently experiencing any of the following symptoms? [Running nose] |
No |
Are you currently experiencing any of the following symptoms? [Sore throat] |
No |
Are you currently experiencing any of the following symptoms? [Nausea] |
No |
Are you currently experiencing any of the following symptoms? [Vomiting] |
No |
Are you currently experiencing any of the following symptoms? [Abdominal Pain] |
No |
Are you currently experiencing any of the following symptoms? [Diarrhea] |
No |
Are you currently experiencing any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
Are you currently experiencing any of the following symptoms? [Loss of sense of smell] |
No |
Are you currently experiencing any of the following symptoms? [Loss of sense of taste] |
No |
Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
Harvard PGP: COVID-19 Health Assessment for Week of 5 April - 11 April 2020
|
Responses submitted 4/6/2020 13:57:14.
Show responses
|
Timestamp |
4/6/2020 13:57:14 |
Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
Currently are you experiencing ANY of the above list of symptoms? |
No |
In the past two weeks, have you experienced ANY of the above list of symptoms? |
Yes |
In the past 2 weeks, which symptoms have you experienced. [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
In the past 2 weeks, which symptoms have you experienced. [Feeling cold, chills or shivers] |
No |
In the past 2 weeks, which symptoms have you experienced. [Headache] |
No |
In the past 2 weeks, which symptoms have you experienced. [Aches all over the body] |
No |
In the past 2 weeks, which symptoms have you experienced. [Cough] |
No |
In the past 2 weeks, which symptoms have you experienced. [Rapid breathing] |
No |
In the past 2 weeks, which symptoms have you experienced. [Shortness of breath] |
No |
In the past 2 weeks, which symptoms have you experienced. [Wheezing or chest tightness] |
No |
In the past 2 weeks, which symptoms have you experienced. [Persistent pain or pressure in the chest] |
No |
In the past 2 weeks, which symptoms have you experienced. [Bluish lips or face] |
No |
In the past 2 weeks, which symptoms have you experienced. [Dizziness] |
No |
In the past 2 weeks, which symptoms have you experienced. [Confusion or inability to arouse] |
No |
In the past 2 weeks, which symptoms have you experienced. [Running nose] |
Yes |
In the past 2 weeks, which symptoms have you experienced. [Sore throat] |
No |
In the past 2 weeks, which symptoms have you experienced. [Nausea] |
No |
In the past 2 weeks, which symptoms have you experienced. [Vomiting] |
No |
In the past 2 weeks, which symptoms have you experienced. [Abdominal pain] |
No |
In the past 2 weeks, which symptoms have you experienced. [Diarrhea] |
Yes |
In the past 2 weeks, which symptoms have you experienced. [Pink eye (conjunctivitis)] |
No |
In the past 2 weeks, which symptoms have you experienced. [Loss of sense of smell] |
No |
In the past 2 weeks, which symptoms have you experienced. [Loss of sense of taste] |
No |
Since Jan 1, 2020, to the best of your recollection,have you experienced ANY of the above list of symptoms? |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Feeling cold, chills or shivers] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Headache] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Aches all over the body] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Cough] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Rapid breathing] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Shortness of breath] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Wheezing or chest tightness] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Persistent pain or pressure in the chest] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Bluish lips or face] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Dizziness] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Confusion or inability to arouse] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Running nose] |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Sore throat] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Nausea] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Vomiting] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Abdominal pain] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Diarrhea] |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Pink eye (conjunctivitis)] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of smell] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of taste] |
No |
Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
Harvard PGP COVID-19 Health Assessment Week 4: 12 April - 18 April 2020
|
Responses submitted 4/13/2020 17:54:02.
Show responses
|
Timestamp |
4/13/2020 17:54:02 |
Are you currently ill with a cold or flu-like illness? |
No |
Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
Currently are you experiencing ANY of the above list of symptoms? |
Yes |
Indicate which of the following symptoms you are currently experiencing. [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
Indicate which of the following symptoms you are currently experiencing. [Feeling cold, chills or shivers] |
No |
Indicate which of the following symptoms you are currently experiencing. [Headache] |
No |
Indicate which of the following symptoms you are currently experiencing. [Aches all over the body] |
No |
Indicate which of the following symptoms you are currently experiencing. [Cough] |
No |
Indicate which of the following symptoms you are currently experiencing. [Rapid breathing] |
No |
Indicate which of the following symptoms you are currently experiencing. [Shortness of breath] |
No |
Indicate which of the following symptoms you are currently experiencing. [Wheezing or chest tightness] |
No |
Indicate which of the following symptoms you are currently experiencing. [Persistent pain or pressure in the chest] |
No |
Indicate which of the following symptoms you are currently experiencing. [Bluish lips or face] |
No |
Indicate which of the following symptoms you are currently experiencing. [Dizziness] |
No |
Indicate which of the following symptoms you are currently experiencing. [Confusion or inability to arouse] |
No |
Indicate which of the following symptoms you are currently experiencing. [Running nose] |
No |
Indicate which of the following symptoms you are currently experiencing. [Sore throat] |
No |
Indicate which of the following symptoms you are currently experiencing. [Nausea] |
No |
Indicate which of the following symptoms you are currently experiencing. [Vomiting] |
No |
Indicate which of the following symptoms you are currently experiencing. [Abdominal Pain] |
No |
Indicate which of the following symptoms you are currently experiencing. [Diarrhea] |
Yes |
Indicate which of the following symptoms you are currently experiencing. [Pink eye (conjunctivitis)] |
No |
Indicate which of the following symptoms you are currently experiencing. [Loss of sense of smell] |
No |
Indicate which of the following symptoms you are currently experiencing. [Loss of sense of taste] |
No |
In the past two weeks, have you experienced ANY of the above list of symptoms? |
Yes |
In the past 2 weeks, which symptoms have you experienced. [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
In the past 2 weeks, which symptoms have you experienced. [Feeling cold, chills or shivers] |
No |
In the past 2 weeks, which symptoms have you experienced. [Headache] |
No |
In the past 2 weeks, which symptoms have you experienced. [Aches all over the body] |
No |
In the past 2 weeks, which symptoms have you experienced. [Cough] |
No |
In the past 2 weeks, which symptoms have you experienced. [Rapid breathing] |
No |
In the past 2 weeks, which symptoms have you experienced. [Shortness of breath] |
No |
In the past 2 weeks, which symptoms have you experienced. [Wheezing or chest tightness] |
No |
In the past 2 weeks, which symptoms have you experienced. [Persistent pain or pressure in the chest] |
No |
In the past 2 weeks, which symptoms have you experienced. [Bluish lips or face] |
No |
In the past 2 weeks, which symptoms have you experienced. [Dizziness] |
No |
In the past 2 weeks, which symptoms have you experienced. [Confusion or inability to arouse] |
No |
In the past 2 weeks, which symptoms have you experienced. [Running nose] |
Yes |
In the past 2 weeks, which symptoms have you experienced. [Sore throat] |
No |
In the past 2 weeks, which symptoms have you experienced. [Nausea] |
No |
In the past 2 weeks, which symptoms have you experienced. [Vomiting] |
No |
In the past 2 weeks, which symptoms have you experienced. [Abdominal pain] |
No |
In the past 2 weeks, which symptoms have you experienced. [Diarrhea] |
Yes |
In the past 2 weeks, which symptoms have you experienced. [Pink eye (conjunctivitis)] |
No |
In the past 2 weeks, which symptoms have you experienced. [Loss of sense of smell] |
No |
In the past 2 weeks, which symptoms have you experienced. [Loss of sense of taste] |
No |
Since Jan 1, 2020, to the best of your recollection,have you experienced ANY of the above list of symptoms? |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Feeling cold, chills or shivers] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Headache] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Aches all over the body] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Cough] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Rapid breathing] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Shortness of breath] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Wheezing or chest tightness] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Persistent pain or pressure in the chest] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Bluish lips or face] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Dizziness] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Confusion or inability to arouse] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Running nose] |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Sore throat] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Nausea] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Vomiting] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Abdominal pain] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Diarrhea] |
Yes |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Pink eye (conjunctivitis)] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of smell] |
No |
Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of taste] |
No |
Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
Harvard PGP COVID-19 Health Assessment [Ongoing]
|
Responses submitted 5/27/2020 20:10:38.
Show responses
|
Timestamp |
5/27/2020 20:10:38 |
Are you currently ill with a cold or flu-like illness? |
No |
Currently are you experiencing ANY of the above list of symptoms? |
No |
In the past two weeks, have you experienced ANY of the above list of symptoms? |
No |
Are you regularly taking any of the following medications? Please choose all those that apply. |
Ibuprofen (eg. Advil, Midol, Motrin, Motrin IB, Motrin Migraine Pain, Proprinal) |
Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
Harvard PGP COVID-19 Health Assessment [Ongoing]
|
Responses submitted 6/12/2020 12:21:22.
Show responses
|
Timestamp |
6/12/2020 12:21:22 |
Are you currently ill with a cold or flu-like illness? |
No |
Currently are you experiencing ANY of the above list of symptoms? |
No |
In the past two weeks, have you experienced ANY of the above list of symptoms? |
No |
Are you regularly taking any of the following medications? Please choose all those that apply. |
Ibuprofen (eg. Advil, Midol, Motrin, Motrin IB, Motrin Migraine Pain, Proprinal) |
Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |