|
PGP Participant Survey
|
Responses submitted 11/1/2011 15:38:29.
Show responses
|
| Timestamp |
11/1/2011 15:38:29 |
| 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. |
seizure disorder that might be mitochondrial based, son with significant clinical features of mitochondrial disease, I have had numerous rare reactions to a variety of types of medications including life threatening reactions |
| Disease/trait: Onset |
40-49 years of age |
| Disease/trait: Rarity |
Very rare/uncommon |
| Disease/trait: Severity |
Moderate severity disease |
| Disease/trait: Relative enrollment |
Yes, I have one or more affected relatives who have expressed an interest |
| Disease/trait: Diagnosis |
No |
| 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? |
No |
| Have you uploaded health record data using our Google Health or Microsoft Healthvault interfaces? |
No, but I plan to |
| Blood sample |
Yes |
| Saliva sample |
Yes |
| Microbiome samples |
Yes |
| Tissue samples from surgery |
Yes |
| Tissue samples from autopsy |
Yes |
|
PGP Participant Survey
|
Responses submitted 11/23/2011 11:58:13.
Show responses
|
| Timestamp |
11/23/2011 11:58:13 |
| Year of birth |
50-59 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. |
son suspected in having a mitochondrial disorder with numerous chronic health issues typical for mito, I developed adult onset seizures with no known cause, with numerous rare reactions to medications such as phenobarbital and tegretol, half sister having EEG today for adult onset seizures similar age to my onset |
| Disease/trait: Onset |
30-39 years of age |
| Disease/trait: Rarity |
Uncommon |
| Disease/trait: Severity |
Moderate severity disease |
| Disease/trait: Relative enrollment |
Maybe |
| Disease/trait: Diagnosis |
Yes |
| Disease/trait: Genetic confirmation |
No |
| Disease/trait: Documentation |
Yes |
| Disease/trait: Documentation description |
EEG results, some DNA analysis completed related to mito with a trait identified in both son and self that may or may not be indicative of an issue |
| 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? |
No, but I plan to |
| Blood sample |
Yes |
| Saliva sample |
Yes |
| Microbiome samples |
Yes |
| Tissue samples from surgery |
No |
| Tissue samples from autopsy |
Yes |
|
PGP Participant Survey
|
Responses submitted 11/28/2011 19:46:46.
Show responses
|
| Timestamp |
11/28/2011 19:46:46 |
| Year of birth |
50-59 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. |
Son and I have novel homoplasmic mutation formally designated as 14751C>T leading to an amino acid change from threonine to isoleucine
I have also had rare life threatening reactions to tegretol and phenobarbital, adult onset seizures unknown origin |
| Disease/trait: Onset |
30-39 years of age |
| Disease/trait: Rarity |
Uncommon |
| Disease/trait: Severity |
Low severity disease |
| Disease/trait: Relative enrollment |
Maybe |
| Disease/trait: Diagnosis |
No |
| 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? |
No, but I plan to |
| Blood sample |
Yes |
| Saliva sample |
Yes |
| Microbiome samples |
Yes |
| Tissue samples from surgery |
Yes |
|
PGP Participant Survey
|
Responses submitted 3/17/2012 18:17:34.
Show responses
|
| Timestamp |
3/17/2012 18:17:34 |
| Year of birth |
50-59 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. |
mitochondrial myopothy |
| Disease/trait: Onset |
40-49 years of age |
| Disease/trait: Rarity |
Uncommon |
| Disease/trait: Severity |
Low severity disease |
| Disease/trait: Relative enrollment |
Yes, I have one or more affected relatives who have expressed an interest |
| Disease/trait: Diagnosis |
No |
| 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 |
No |
| Uploaded health records: Extensiveness |
1 |
| Blood sample |
Yes |
| Saliva sample |
Yes |
| Microbiome samples |
Yes |
| Tissue samples from surgery |
Yes |
| Tissue samples from autopsy |
Yes |
|
PGP Participant Survey
|
Responses submitted 5/7/2012 0:00:32.
Show responses
|
| Timestamp |
5/7/2012 0:00:32 |
| Year of birth |
50-59 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. |
Family history of mitochondrial disorder |
| Disease/trait: Onset |
40-49 years of age |
| Disease/trait: Rarity |
Uncommon |
| Disease/trait: Severity |
Low severity disease |
| Disease/trait: Relative enrollment |
Maybe |
| Disease/trait: Diagnosis |
No |
| 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 |
No |
| Uploaded health records: Extensiveness |
1 |
| 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 11/11/2012 19:59:27.
Show responses
|
| Timestamp |
11/11/2012 19:59:27 |
| Have you ever been diagnosed with one of the following conditions? |
Cervical cancer |
|
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 11/11/2012 20:00:08.
Show responses
|
| Timestamp |
11/11/2012 20:00:08 |
|
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 11/11/2012 20:00:47.
Show responses
|
| Timestamp |
11/11/2012 20:00:47 |
|
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 11/11/2012 20:01:06.
Show responses
|
| Timestamp |
11/11/2012 20:01:06 |
|
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 11/11/2012 20:01:37.
Show responses
|
| Timestamp |
11/11/2012 20:01:37 |
| Have you ever been diagnosed with one of the following conditions? |
Restless legs syndrome, Epilepsy |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 11/11/2012 20:02:25.
Show responses
|
| Timestamp |
11/11/2012 20:02:25 |
| Have you ever been diagnosed with one of the following conditions? |
Presbyopia, Age-related hearing loss |
|
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 11/11/2012 20:02:57.
Show responses
|
| Timestamp |
11/11/2012 20:02:57 |
|
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 11/11/2012 20:03:15.
Show responses
|
| Timestamp |
11/11/2012 20:03:15 |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 11/11/2012 20:04:31.
Show responses
|
| Timestamp |
11/11/2012 20:04:31 |
| Have you ever been diagnosed with any of the following conditions? |
Dental cavities, Canker sores (oral ulcers), Peptic ulcer (stomach or duodenum) |
|
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 11/11/2012 20:05:11.
Show responses
|
| Timestamp |
11/11/2012 20:05:11 |
| Have you ever been diagnosed with any of the following conditions? |
Urinary tract infection (UTI), Fibrocystic breast disease, Endometriosis, Ovarian cysts |
|
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 11/11/2012 20:05:39.
Show responses
|
| Timestamp |
11/11/2012 20:05:39 |
| Have you ever been diagnosed with any of the following conditions? |
Rosacea, Skin tags |
|
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 11/11/2012 20:06:14.
Show responses
|
| Timestamp |
11/11/2012 20:06:14 |
|
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 11/11/2012 20:06:44.
Show responses
|
| Timestamp |
11/11/2012 20:06:44 |
| Have you ever been diagnosed with any of the following conditions? |
Tongue tie (ankyloglossia) |
|
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 12/28/2012 19:41:32.
Show responses
|
| Timestamp |
12/28/2012 19:41:32 |
| Have you ever been diagnosed with any of the following conditions? |
Urinary tract infection (UTI), Fibrocystic breast disease, Endometriosis |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 12/28/2012 19:42:40.
Show responses
|
| Timestamp |
12/28/2012 19:42:40 |
| Have you ever been diagnosed with any of the following conditions? |
Dental cavities |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 3/7/2013 22:04:32.
Show responses
|
| Timestamp |
3/7/2013 22:04:32 |
| Have you ever been diagnosed with any of the following conditions? |
Gallstones |
| Other condition not listed here? |
Gallbladder removed 3/2013 |
|
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 5/12/2013 19:52:30.
Show responses
|
| Timestamp |
5/12/2013 19:52:30 |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 12/11/2013 17:01:07.
Show responses
|
| Timestamp |
12/11/2013 17:01:07 |
| Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness) |
| Other condition not listed here? |
macular retinopathy not age or diabetic related |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 1/3/2014 18:15:01.
Show responses
|
| Timestamp |
1/3/2014 18:15:01 |
| Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness) |
| Other condition not listed here? |
Macular damage unknown origin |
|
PGP Participant Survey
|
Responses submitted 2/7/2014 12:20:52.
Show responses
|
| Timestamp |
2/7/2014 12:20:52 |
| Year of birth |
1961 |
| Do you have a severe genetic disease or rare genetic trait? If so, you can add a description for your public profile. |
Heterozygous CYP2D6*1/*4
Homozygous CYP2C19*1/*1 |
| 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 |
November |
| 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 2/7/2014 12:23:49.
Show responses
|
| Timestamp |
2/7/2014 12:23:49 |
| Have you ever been diagnosed with one of the following conditions? |
Colon polyps, Cervical cancer |
|
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 2/7/2014 12:25:26.
Show responses
|
| Timestamp |
2/7/2014 12:25:26 |
| Have you ever been diagnosed with one of the following conditions? |
Restless legs syndrome, Epilepsy |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 2/7/2014 12:26:39.
Show responses
|
| Timestamp |
2/7/2014 12:26:39 |
| Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness) |
| Other condition not listed here? |
Macular scarring |
|
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 2/7/2014 12:27:17.
Show responses
|
| Timestamp |
2/7/2014 12:27:17 |
| Have you ever been diagnosed with one of the following conditions? |
Hemorrhoids |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 2/7/2014 12:28:28.
Show responses
|
| Timestamp |
2/7/2014 12:28:28 |
| Have you ever been diagnosed with any of the following conditions? |
Dental cavities, Peptic ulcer (stomach or duodenum), Gallstones |
|
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 2/7/2014 12:29:10.
Show responses
|
| Timestamp |
2/7/2014 12:29:10 |
| Have you ever been diagnosed with any of the following conditions? |
Fibrocystic breast disease, Endometriosis, Ovarian cysts |
|
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 2/7/2014 12:29:42.
Show responses
|
| Timestamp |
2/7/2014 12:29:42 |
| Have you ever been diagnosed with any of the following conditions? |
Rosacea |
|
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 2/7/2014 12:30:40.
Show responses
|
| Timestamp |
2/7/2014 12:30:40 |
| Have you ever been diagnosed with any of the following conditions? |
Tongue tie (ankyloglossia) |
|
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 7/28/2014 16:53:06.
Show responses
|
| Timestamp |
7/28/2014 16:53:06 |
| Have you ever been diagnosed with any of the following conditions? |
Urinary tract infection (UTI), Fibrocystic breast disease, Endometriosis, Ovarian cysts |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 7/28/2014 16:53:53.
Show responses
|
| Timestamp |
7/28/2014 16:53:53 |
| Have you ever been diagnosed with any of the following conditions? |
Dental cavities, Peptic ulcer (stomach or duodenum), Gallstones |
|
PGP Participant Survey
|
Responses submitted 11/29/2014 10:09:24.
Show responses
|
| Timestamp |
11/29/2014 10:09:24 |
| Year of birth |
1961 |
| Do you have a severe genetic disease or rare genetic trait? If so, you can add a description for your public profile. |
Son has mitochondrial disease, I have minor similar traits. |
| 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 |
November |
| 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: Vision and hearing
|
Responses submitted 3/20/2015 17:37:19.
Show responses
|
| Timestamp |
3/20/2015 17:37:19 |
| Have you ever been diagnosed with one of the following conditions? |
Hyperopia (Farsightedness), Myopia (Nearsightedness), Tinnitus |
|
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 8/10/2015 20:51:41.
Show responses
|
| Timestamp |
8/10/2015 20:51:41 |
| Have you ever been diagnosed with any of the following conditions? |
Tongue tie (ankyloglossia) |
|
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 8/10/2015 20:52:14.
Show responses
|
| Timestamp |
8/10/2015 20:52:14 |
|
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 8/10/2015 20:52:51.
Show responses
|
| Timestamp |
8/10/2015 20:52:51 |
| Have you ever been diagnosed with any of the following conditions? |
Urinary tract infection (UTI), Fibrocystic breast disease, Endometriosis, Ovarian cysts |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 8/10/2015 20:53:27.
Show responses
|
| Timestamp |
8/10/2015 20:53:27 |
| Have you ever been diagnosed with one of the following conditions? |
Hyperopia (Farsightedness), Myopia (Nearsightedness), Tinnitus |
|
PGP Participant Survey
|
Responses submitted 8/10/2015 20:55:03.
Show responses
|
| Timestamp |
8/10/2015 20:55:03 |
| Year of birth |
1961 |
| 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 |
November |
| 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 8/10/2015 20:55:36.
Show responses
|
| Timestamp |
8/10/2015 20:55:36 |
| Have you ever been diagnosed with one of the following conditions? |
Colon polyps, Cervical cancer |
|
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 8/10/2015 20:56:04.
Show responses
|
| Timestamp |
8/10/2015 20:56:04 |
|
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 8/10/2015 20:56:33.
Show responses
|
| Timestamp |
8/10/2015 20:56:33 |
|
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 8/10/2015 20:56:59.
Show responses
|
| Timestamp |
8/10/2015 20:56:59 |
| Have you ever been diagnosed with one of the following conditions? |
Restless legs syndrome, Epilepsy |
|
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 8/10/2015 20:57:33.
Show responses
|
| Timestamp |
8/10/2015 20:57:33 |
| Have you ever been diagnosed with one of the following conditions? |
Hemorrhoids |
|
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 8/10/2015 20:57:54.
Show responses
|
| Timestamp |
8/10/2015 20:57:54 |
|
PGP Basic Phenotypes Survey 2015
|
Responses submitted 8/29/2015 20:06:03.
Show responses
|
| Timestamp |
8/29/2015 20:06:03 |
| 1.1 — Blood Type |
B + |
| 1.2 — Height |
5'5" |
| 1.3 — Weight |
135 |
| 2.1 — Left Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
19 |
| 2.2 — Right Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
19 |
| 2.3 — Left Eye Color - Text Description |
Strong outer ring, green to light brown |
| 2.4 — Right Eye Color - Text Description |
Dark utter ring more dominant than left and green to light brown |
| 2.5 —Comments |
Left eye has scaring similar to macular degeneration but eye doctor thinks is maybe mitochondrial related, as no progression for decade. |
| 3.1 — What is your natural hair color currently, when without artificial color or dye? |
brown |
| 3.2 — Hair Color - Text Description |
Basic brown, small blonde shiock on left side |
| 3.3 — Comments |
Some reddish highlight naturally |
| 1.4 — Handedness |
Both equally well |
|
Harvard PGP: COVID-19 Demographics Survey
|
Responses submitted 3/23/2020 18:55:45.
Show responses
|
| Timestamp |
3/23/2020 18:55:45 |
| What is the zip code of your primary residence? |
17815 |
| Do have another residence where you spend more than 30 days a year? |
No |
| What is your age (in years)? |
58 |
| What is your gender? |
Female |
| Select all the following that apply to your current living arrangements. |
Live with partner/spouse, Other, Son age 28 |
| 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? |
Yes |
| Do you currently smoke tobacco products? |
No |
| What is the average number of cigarettes (# of cigarettes not packs) you smoke per day? |
Don't currently smoke |
| 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. |
Management |
| What is the zip code of your primary workplace/worksite? |
17815 |
| 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 22-28 March 2020
|
Responses submitted 3/23/2020 18:57:56.
Show responses
|
| Timestamp |
3/23/2020 18:57:56 |
| 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] |
Yes |
| 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] |
No |
| 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] |
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] |
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 29 March- 4 April 2020
|
Responses submitted 3/30/2020 12:43:47.
Show responses
|
| Timestamp |
3/30/2020 12:43:47 |
| 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] |
Yes |
| 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] |
No |
| 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] |
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] |
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 4/12/2020 13:25:43.
Show responses
|
| Timestamp |
4/12/2020 13:25:43 |
| 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? |
No |
| Since Jan 1, 2020, to the best of your recollection,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. |
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 4/20/2020 8:31:33.
Show responses
|
| Timestamp |
4/20/2020 8:31:33 |
| 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] |
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] |
No |
| Indicate which of the following symptoms you are currently experiencing. [Sore throat] |
Yes |
| 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? |
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] |
No |
| 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. |
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 4/24/2020 18:53:04.
Show responses
|
| Timestamp |
4/24/2020 18:53:04 |
| Are you currently ill with a cold or flu-like illness? |
Yes |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
Yes |
| 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] |
Yes |
| Indicate which of the following symptoms you are currently experiencing. [Headache] |
Yes |
| Indicate which of the following symptoms you are currently experiencing. [Aches all over the body] |
Yes |
| 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] |
Yes |
| 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] |
Yes |
| Indicate which of the following symptoms you are currently experiencing. [Nausea] |
Yes |
| 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] |
Yes |
| In the past 2 weeks, which symptoms have you experienced. [Headache] |
Yes |
| 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] |
Yes |
| 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] |
No |
| 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? |
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 tried to get tested but could not get a test |
| 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 6/14/2020 8:38:01.
Show responses
|
| Timestamp |
6/14/2020 8:38:01 |
| 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. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
Yes, and the test was negative for coronavirus (COVID-19) |
| 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 |
