|
PGP Participant Survey
|
Responses submitted 11/4/2014 15:12:14.
Show responses
|
| Timestamp |
11/4/2014 15:12:14 |
| Year of birth |
1948 |
| Sex/Gender |
Male |
| 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 |
March |
| Anatomical sex at birth |
Male |
| 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 11/4/2014 15:14:14.
Show responses
|
| Timestamp |
11/4/2014 15:14:14 |
| Have you ever been diagnosed with one of the following conditions? |
Non-melanoma skin cancer |
|
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 11/4/2014 15:14:51.
Show responses
|
| Timestamp |
11/4/2014 15:14:51 |
| Have you ever been diagnosed with any of the following conditions? |
High cholesterol (hypercholesterolemia) |
|
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 11/4/2014 15:15:35.
Show responses
|
| Timestamp |
11/4/2014 15:15:35 |
|
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 11/4/2014 15:16:20.
Show responses
|
| Timestamp |
11/4/2014 15:16:20 |
| Have you ever been diagnosed with one of the following conditions? |
Migraine without aura |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 11/4/2014 15:19:37.
Show responses
|
| Timestamp |
11/4/2014 15:19:37 |
| Have you ever been diagnosed with one of the following conditions? |
Astigmatism, Presbyopia, Floaters, Age-related hearing loss, Tinnitus |
|
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 11/4/2014 15:22:40.
Show responses
|
| Timestamp |
11/4/2014 15:22:40 |
| Have you ever been diagnosed with one of the following conditions? |
Premature ventricular contractions, Cardiac arrhythmia, Hemorrhoids |
| Other condition not listed here? |
Premature atrial contractions |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 11/4/2014 15:27:51.
Show responses
|
| Timestamp |
11/4/2014 15:27:51 |
| Have you ever been diagnosed with any of the following conditions? |
Impacted tooth, Dental cavities, Gastroesophageal reflux disease (GERD), Inguinal hernia, Diverticulosis |
|
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 11/4/2014 15:31:39.
Show responses
|
| Timestamp |
11/4/2014 15:31:39 |
| Have you ever been diagnosed with any of the following conditions? |
Dandruff, Skin tags, Hyperhidrosis (excessive sweating), Acne |
|
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 11/4/2014 15:43:38.
Show responses
|
| Timestamp |
11/4/2014 15:43:38 |
| Have you ever been diagnosed with any of the following conditions? |
Spinal stenosis |
|
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 11/4/2014 15:44:37.
Show responses
|
| Timestamp |
11/4/2014 15:44:37 |
|
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 11/4/2014 15:50:36.
Show responses
|
| Timestamp |
11/4/2014 15:50:36 |
| Have you ever been diagnosed with any of the following conditions? |
Deviated septum, Allergic rhinitis |
|
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 11/4/2014 15:51:25.
Show responses
|
| Timestamp |
11/4/2014 15:51:25 |
| Have you ever been diagnosed with any of the following conditions? |
Urinary tract infection (UTI) |
|
PGP Participant Survey
|
Responses submitted 8/29/2015 15:12:30.
Show responses
|
| Timestamp |
8/29/2015 15:12:30 |
| Year of birth |
1948 |
| Sex/Gender |
Male |
| 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 |
Poland |
| Month of birth |
March |
| Anatomical sex at birth |
Male |
| Maternal grandmother: Race/ethnicity |
White |
| Maternal grandfather: Race/ethnicity |
White |
| Paternal grandmother: Race/ethnicity |
White |
| Paternal grandfather: Race/ethnicity |
White |
|
PGP Participant Survey
|
Responses submitted 8/29/2015 15:16:12.
Show responses
|
| Timestamp |
8/29/2015 15:16:12 |
| Year of birth |
1948 |
| Sex/Gender |
Male |
| 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 |
Poland |
| Month of birth |
March |
| Anatomical sex at birth |
Male |
| Maternal grandmother: Race/ethnicity |
White |
| Maternal grandfather: Race/ethnicity |
White |
| Paternal grandmother: Race/ethnicity |
White |
| Paternal grandfather: Race/ethnicity |
White |
|
PGP Participant Survey
|
Responses submitted 11/20/2015 22:31:26.
Show responses
|
| Timestamp |
11/20/2015 22:31:26 |
| Year of birth |
1948 |
| Do you have a severe genetic disease or rare genetic trait? If so, you can add a description for your public profile. |
no genetic disease or rare traits |
| Sex/Gender |
Male |
| 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 |
Poland |
| Month of birth |
March |
| Anatomical sex at birth |
Male |
| Maternal grandmother: Race/ethnicity |
White |
| Maternal grandfather: Race/ethnicity |
White |
| Paternal grandmother: Race/ethnicity |
White |
| Paternal grandfather: Race/ethnicity |
White |
|
PGP Basic Phenotypes Survey 2015
|
Responses submitted 11/20/2015 22:38:07.
Show responses
|
| Timestamp |
11/20/2015 22:38:07 |
| 1.1 — Blood Type |
A - |
| 1.2 — Height |
5'9" |
| 1.3 — Weight |
184 |
| 2.1 — Left Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
4 |
| 2.2 — Right Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
4 |
| 2.3 — Left Eye Color - Text Description |
blue |
| 2.4 — Right Eye Color - Text Description |
same |
| 3.1 — What is your natural hair color currently, when without artificial color or dye? |
gray |
| 3.2 — Hair Color - Text Description |
gray |
| 3.3 — Comments |
Born blond hair. Blond/brownish in adulthood. Gray in old age. |
| 1.4 — Handedness |
Right |
|
Harvard PGP: COVID-19 Demographics Survey
|
Responses submitted 3/24/2020 16:20:38.
Show responses
|
| Timestamp |
3/24/2020 16:20:38 |
| What is the zip code of your primary residence? |
92677-2093 |
| Do have another residence where you spend more than 30 days a year? |
No |
| What is your age (in years)? |
71 |
| What is your gender? |
Male |
| Select all the following that apply to your current living arrangements. |
Live alone |
| 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] |
No |
| 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? |
Retired |
|
Harvard PGP: COVID-19 Health Assessment for Week of 29 March- 4 April 2020
|
Responses submitted 3/30/2020 15:46:09.
Show responses
|
| Timestamp |
3/30/2020 15:46:09 |
| 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] |
Yes |
| 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] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Sore throat] |
Yes |
| 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] |
No |
| 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] |
Yes |
| 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. |
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 Demographics Survey
|
Responses submitted 3/30/2020 15:48:43.
Show responses
|
| Timestamp |
3/30/2020 15:48:43 |
| What is the zip code of your primary residence? |
92677-2093 |
| Do have another residence where you spend more than 30 days a year? |
No |
| What is your age (in years)? |
71 |
| What is your gender? |
Male |
| Select all the following that apply to your current living arrangements. |
Live alone |
| 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] |
No |
| 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? |
Retired |
|
Harvard PGP: COVID-19 Health Assessment for Week of 5 April - 11 April 2020
|
Responses submitted 4/6/2020 14:08:50.
Show responses
|
| Timestamp |
4/6/2020 14:08:50 |
| 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] |
Yes |
| 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] |
Yes |
| 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] |
No |
| 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] |
Yes |
| 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] |
No |
| 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] |
Yes |
| 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] |
Yes |
| 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] |
No |
| 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. |
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 Week 4: 12 April - 18 April 2020
|
Responses submitted 4/16/2020 14:21:11.
Show responses
|
| Timestamp |
4/16/2020 14:21:11 |
| 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? |
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] |
Yes |
| 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] |
No |
| 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] |
Yes |
| 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] |
Yes |
| 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] |
No |
| 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. |
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 |
