PGP Participant Survey
|
Responses submitted 8/3/2011 9:09:43.
Show responses
|
Timestamp |
8/3/2011 9:09:43 |
Year of birth |
21-29 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 |
No |
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 |
Enrollment of relatives |
No |
Enrollment of older individuals |
No |
Enrollment of parents |
Maybe |
Have you uploaded genetic data to your PGP participant profile? |
No, I have no genetic data. |
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 Fall/Winter 2011 Saliva Kit: Small Tube Collection Survey
|
Responses submitted 10/31/2011 20:20:44.
Show responses
|
Timestamp |
10/31/2011 20:20:44 |
Which sample tube did you just collect? |
Small tube |
How easy was this sample tube to use for collection? |
5 |
Do you have any gum bleeding or gingivitis (gum inflammation)? |
No |
Did you collect this sample all at once, or at multiple timepoints? |
Multiple timepoints |
If you have any specific comments regarding the sample you collected with this sample tube, please note them here. |
Very simple. |
PGP Fall/Winter 2011 Saliva Kit: Large Tube Collection Survey
|
Responses submitted 10/31/2011 20:22:00.
Show responses
|
Timestamp |
10/31/2011 20:22:00 |
Which sample tube did you just collect? |
Big tube |
How easy was this sample tube to use for collection? |
5 |
Do you have any gum bleeding or gingivitis (gum inflammation)? |
No |
Did you collect this sample all at once, or at multiple timepoints? |
Multiple timepoints |
If you have any specific comments regarding the sample you collected with this sample tube, please note them here. |
Very simple. |
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 10/10/2012 9:15:32.
Show responses
|
Timestamp |
10/10/2012 9:15:32 |
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 10/10/2012 9:16:11.
Show responses
|
Timestamp |
10/10/2012 9:16:11 |
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 10/10/2012 9:16:56.
Show responses
|
Timestamp |
10/10/2012 9:16:56 |
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 10/10/2012 9:17:21.
Show responses
|
Timestamp |
10/10/2012 9:17:21 |
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 10/10/2012 9:18:14.
Show responses
|
Timestamp |
10/10/2012 9:18:14 |
Have you ever been diagnosed with any of the following conditions? |
Dental cavities |
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 10/10/2012 9:18:34.
Show responses
|
Timestamp |
10/10/2012 9:18:34 |
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 10/10/2012 9:19:21.
Show responses
|
Timestamp |
10/10/2012 9:19:21 |
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 10/10/2012 9:20:18.
Show responses
|
Timestamp |
10/10/2012 9:20:18 |
Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness) |
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 10/10/2012 9:21:04.
Show responses
|
Timestamp |
10/10/2012 9:21:04 |
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 10/10/2012 9:21:34.
Show responses
|
Timestamp |
10/10/2012 9:21:34 |
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 10/10/2012 9:22:04.
Show responses
|
Timestamp |
10/10/2012 9:22:04 |
PGP Trait & Disease Survey 2012: Cancers
|
Responses submitted 10/10/2012 9:22:44.
Show responses
|
Timestamp |
10/10/2012 9:22:44 |
PGP Trait & Disease Survey 2012: Cancers
|
Responses submitted 10/12/2012 9:01:15.
Show responses
|
Timestamp |
10/12/2012 9:01:15 |
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 10/12/2012 9:01:45.
Show responses
|
Timestamp |
10/12/2012 9:01:45 |
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 10/12/2012 9:02:40.
Show responses
|
Timestamp |
10/12/2012 9:02:40 |
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 10/12/2012 9:03:15.
Show responses
|
Timestamp |
10/12/2012 9:03:15 |
Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness) |
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 10/12/2012 9:03:35.
Show responses
|
Timestamp |
10/12/2012 9:03:35 |
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 10/12/2012 9:04:53.
Show responses
|
Timestamp |
10/12/2012 9:04:53 |
Have you ever been diagnosed with any of the following conditions? |
Dental cavities |
PGP Trait & Disease Survey 2012: Genitourinary Systems
|
Responses submitted 10/12/2012 9:05:37.
Show responses
|
Timestamp |
10/12/2012 9:05:37 |
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 10/12/2012 9:06:04.
Show responses
|
Timestamp |
10/12/2012 9:06:04 |
Have you ever been diagnosed with any of the following conditions? |
Cafe au lait spots |
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 10/12/2012 9:06:20.
Show responses
|
Timestamp |
10/12/2012 9:06:20 |
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 10/12/2012 9:06:42.
Show responses
|
Timestamp |
10/12/2012 9:06:42 |
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 10/15/2012 8:59:18.
Show responses
|
Timestamp |
10/15/2012 8:59:18 |
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 10/15/2012 9:00:02.
Show responses
|
Timestamp |
10/15/2012 9:00:02 |
PGP Basic Phenotypes Survey 2015
|
Responses submitted 8/24/2015 23:45:08.
Show responses
|
Timestamp |
8/24/2015 23:45:08 |
1.1 — Blood Type |
A + |
1.2 — Height |
6'0" |
1.3 — Weight |
165 |
2.1 — Left Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
7 |
2.2 — Right Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
7 |
2.3 — Left Eye Color - Text Description |
Gray blue |
2.4 — Right Eye Color - Text Description |
Gray blue |
2.5 —Comments |
To my knowledge, my eye color is no different now than at birth. To my knowledge, my family has no history of a particular eye color, disease, or other irregularity. |
3.1 — What is your natural hair color currently, when without artificial color or dye? |
gray |
3.2 — Hair Color - Text Description |
Salt and pepper (dark brown and gray) |
3.3 — Comments |
My hair was dark brown at birth but is now graying. |
4.1 — Any final thoughts? |
I'm happy to provide any needed information in a follow-up survey. |
1.4 — Handedness |
Right |
Harvard PGP: COVID-19 Demographics Survey
|
Responses submitted 3/23/2020 19:27:11.
Show responses
|
Timestamp |
3/23/2020 19:27:11 |
What is the zip code of your primary residence? |
65203 |
Do have another residence where you spend more than 30 days a year? |
No |
What is your age (in years)? |
38 |
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? |
Yes |
Do you currently smoke tobacco products? |
Yes |
What is the average number of cigarettes (# of cigarettes not packs) you smoke per day? |
less than 5 |
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. |
IT for K12 Public Schools |
What is the zip code of your primary workplace/worksite? |
65203 |
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? |
Yes |
Harvard PGP: COVID-19 Health Assessment for Week of 22-28 March 2020
|
Responses submitted 3/23/2020 19:30:40.
Show responses
|
Timestamp |
3/23/2020 19:30:40 |
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] |
Yes |
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] |
Yes |
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 23:16:31.
Show responses
|
Timestamp |
3/30/2020 23:16:31 |
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] |
Yes |
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] |
Yes |
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 23:23:42.
Show responses
|
Timestamp |
4/6/2020 23:23:42 |
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? |
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] |
Yes |
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] |
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] |
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 4/13/2020 18:25:21.
Show responses
|
Timestamp |
4/13/2020 18:25:21 |
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? |
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 [Ongoing]
|
Responses submitted 5/28/2020 8:59:12.
Show responses
|
Timestamp |
5/28/2020 8:59:12 |
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 |
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)? |
I don't know |
Harvard PGP COVID-19 Health Assessment [Ongoing]
|
Responses submitted 6/12/2020 13:03:39.
Show responses
|
Timestamp |
6/12/2020 13:03:39 |
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? |
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 |