|
PGP Participant Survey
|
Responses submitted 7/26/2011 19:51:31.
Show responses
|
| Timestamp |
7/26/2011 19:51:31 |
| 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. |
Melanoma cancer. Mother had it. Maternal uncle died of Melanoma. I have had one removed and my sister has had one removed. Father had Basel Cell |
| Disease/trait: Onset |
30-39 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 |
Yes |
| Disease/trait: Genetic confirmation |
No |
| Disease/trait: Documentation |
Yes |
| Disease/trait: Documentation description |
I can get doctor's reports on myself and my mother on melanoma. Same doctor removed both of our cancer sites. |
| 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 |
Yes |
| Enrollment of older individuals |
Yes |
| Enrollment of parents |
Yes |
| Enrolled relatives [Parents] |
1 |
| Enrolled relatives [Siblings / Fraternal twins] |
2 or more |
| Enrolled relatives [Nephews/Nieces] |
1 |
| Are all your enrolled relatives linked to your PGP profile? |
Yes |
| 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? |
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 2/1/2012 8:02:17.
Show responses
|
| Timestamp |
2/1/2012 8:02:17 |
| 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. |
Melanoma - Mother has it, Sister, Maternal Uncle all had Melanoma confirmed and removed. Maternal Uncle died from Melanoma |
| Disease/trait: Onset |
Congenital / present at birth |
| Disease/trait: Rarity |
Fairly common |
| Disease/trait: Severity |
Low severity disease |
| Disease/trait: Relative enrollment |
Yes, I have one or more affected relatives and they are already enrolled |
| Disease/trait: Diagnosis |
Yes |
| Disease/trait: Genetic confirmation |
No |
| Disease/trait: Documentation |
Yes |
| Disease/trait: Documentation description |
I have doctor's reports for the removal of the melanoma. I believe that there are lab tests in those records. |
| 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 |
Other / don't know / no response |
| Maternal grandfather: Country of origin |
United States |
| Enrollment of relatives |
Yes |
| Enrollment of older individuals |
Yes |
| Enrollment of parents |
Yes |
| Enrolled relatives [Monozygotic / Identical twins] |
0 |
| Enrolled relatives [Parents] |
1 |
| Enrolled relatives [Siblings / Fraternal twins] |
2 or more |
| Enrolled relatives [Children] |
0 |
| Enrolled relatives [Grandparents] |
0 |
| Enrolled relatives [Grandchildren] |
0 |
| Enrolled relatives [Aunts/Uncles] |
0 |
| Enrolled relatives [Nephews/Nieces] |
2 or more |
| Enrolled relatives [Half-siblings] |
0 |
| Enrolled relatives [Cousins or more distant] |
0 |
| Enrolled relatives [Not genetically related (e.g. husband/wife)] |
0 |
| Are all your enrolled relatives linked to your PGP profile? |
Yes |
| 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? |
No, and I do not 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 5/2/2012 6:31:51.
Show responses
|
| Timestamp |
5/2/2012 6:31:51 |
| 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. |
Melanoma Cancer - Maternal uncle died of it, My mother has had melanoma removed as have I and my sister. My father has basel cell carcenoma |
| Disease/trait: Onset |
Congenital / present at birth |
| Disease/trait: Rarity |
Fairly common |
| Disease/trait: Severity |
Low severity disease |
| Disease/trait: Relative enrollment |
Yes, I have one or more affected relatives and they are already enrolled |
| Disease/trait: Diagnosis |
Yes |
| Disease/trait: Genetic confirmation |
Yes |
| Disease/trait: Documentation |
Yes |
| Disease/trait: Documentation description |
I have the lab reports from the dermatologist confirming the cancet. I would have to find it as it was in 1992 |
| Sex/Gender |
Female |
| Race/ethnicity |
White |
| Maternal grandmother: Country of origin |
Germany |
| Paternal grandmother: Country of origin |
Germany |
| Paternal grandfather: Country of origin |
Germany |
| Maternal grandfather: Country of origin |
United Kingdom |
| Enrollment of relatives |
Yes |
| Enrollment of older individuals |
Yes |
| Enrollment of parents |
Yes |
| Enrolled relatives [Monozygotic / Identical twins] |
0 |
| Enrolled relatives [Parents] |
1 |
| Enrolled relatives [Siblings / Fraternal twins] |
2 or more |
| Enrolled relatives [Children] |
0 |
| Enrolled relatives [Grandparents] |
0 |
| Enrolled relatives [Grandchildren] |
0 |
| Enrolled relatives [Aunts/Uncles] |
0 |
| Enrolled relatives [Nephews/Nieces] |
0 |
| Enrolled relatives [Half-siblings] |
0 |
| Enrolled relatives [Cousins or more distant] |
0 |
| Enrolled relatives [Not genetically related (e.g. husband/wife)] |
1 |
| Are all your enrolled relatives linked to your PGP profile? |
Yes |
| 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? |
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 11/14/2012 9:30:39.
Show responses
|
| Timestamp |
11/14/2012 9:30:39 |
| Year of birth |
60-69 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. |
Melanoma |
| Disease/trait: Onset |
Congenital / present at birth |
| Disease/trait: Rarity |
Uncommon |
| Disease/trait: Severity |
Low severity disease |
| Disease/trait: Relative enrollment |
Yes, I have one or more affected relatives and they are already enrolled |
| Disease/trait: Diagnosis |
Yes |
| Disease/trait: Genetic confirmation |
No |
| Disease/trait: Documentation |
Yes |
| Disease/trait: Documentation description |
There are autopsie results from biopsies for myself, my mother and my sister. My maternal uncle also had melanoma - |
| Sex/Gender |
Female |
| Race/ethnicity |
White |
| Maternal grandmother: Country of origin |
Germany |
| Paternal grandmother: Country of origin |
United Kingdom |
| Paternal grandfather: Country of origin |
United States |
| Maternal grandfather: Country of origin |
Germany |
| Enrollment of relatives |
Yes |
| Enrollment of older individuals |
Yes |
| Enrollment of parents |
Yes |
| Enrolled relatives [Monozygotic / Identical twins] |
0 |
| Enrolled relatives [Parents] |
1 |
| Enrolled relatives [Siblings / Fraternal twins] |
2 or more |
| Enrolled relatives [Children] |
0 |
| Enrolled relatives [Grandparents] |
0 |
| Enrolled relatives [Grandchildren] |
0 |
| Enrolled relatives [Aunts/Uncles] |
0 |
| Enrolled relatives [Nephews/Nieces] |
1 |
| Enrolled relatives [Half-siblings] |
0 |
| Enrolled relatives [Cousins or more distant] |
0 |
| Enrolled relatives [Not genetically related (e.g. husband/wife)] |
0 |
| Are all your enrolled relatives linked to your PGP profile? |
Yes |
| 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? |
No, and I do not plan to |
| 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 11/14/2012 9:31:24.
Show responses
|
| Timestamp |
11/14/2012 9:31:24 |
| Have you ever been diagnosed with one of the following conditions? |
Melanoma, Non-melanoma skin cancer, Uterine fibroids |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 11/14/2012 9:32:14.
Show responses
|
| Timestamp |
11/14/2012 9:32:14 |
| Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness), Astigmatism, Tinnitus |
|
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 11/14/2012 9:32:56.
Show responses
|
| Timestamp |
11/14/2012 9:32:56 |
| Have you ever been diagnosed with any of the following conditions? |
Eczema, Skin tags, Acne |
|
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 11/14/2012 9:33:22.
Show responses
|
| Timestamp |
11/14/2012 9:33:22 |
|
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 11/14/2012 9:33:47.
Show responses
|
| Timestamp |
11/14/2012 9:33:47 |
| Have you ever been diagnosed with any of the following conditions? |
Iron deficiency anemia |
|
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 11/14/2012 9:34:14.
Show responses
|
| Timestamp |
11/14/2012 9:34:14 |
|
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 11/14/2012 9:34:59.
Show responses
|
| Timestamp |
11/14/2012 9:34:59 |
|
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 11/14/2012 9:35:27.
Show responses
|
| Timestamp |
11/14/2012 9:35:27 |
|
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 11/14/2012 9:35:46.
Show responses
|
| Timestamp |
11/14/2012 9:35:46 |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 11/14/2012 9:36:23.
Show responses
|
| Timestamp |
11/14/2012 9:36:23 |
| Have you ever been diagnosed with any of the following conditions? |
Impacted tooth, Dental cavities |
|
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 11/14/2012 9:36:59.
Show responses
|
| Timestamp |
11/14/2012 9:36:59 |
| Have you ever been diagnosed with any of the following conditions? |
Osteoarthritis, Tennis elbow, Plantar fasciitis |
|
PGP Basic Phenotypes Survey 2015
|
Responses submitted 4/22/2017 9:08:43.
Show responses
|
| Timestamp |
4/22/2017 9:08:43 |
| 1.1 — Blood Type |
O + |
| 1.2 — Height |
5'6" |
| 1.3 — Weight |
160 |
| 2.1 — Left Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
15 |
| 2.2 — Right Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
15 |
| 2.3 — Left Eye Color - Text Description |
hazel |
| 2.4 — Right Eye Color - Text Description |
same |
| 2.5 —Comments |
macular degeneration |
| 3.1 — What is your natural hair color currently, when without artificial color or dye? |
brown |
| 3.2 — Hair Color - Text Description |
brown |
| 1.4 — Handedness |
Right |
|
Harvard PGP: COVID-19 Demographics Survey
|
Responses submitted 3/24/2020 9:13:53.
Show responses
|
| Timestamp |
3/24/2020 9:13:53 |
| What is the zip code of your primary residence? |
43085 |
| Do have another residence where you spend more than 30 days a year? |
No |
| What is your age (in years)? |
67 |
| What is your gender? |
Female |
| Select all the following that apply to your current living arrangements. |
Live with partner/spouse |
| 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? |
Employed: Working 1-39 hrs per week |
| Select the category that best describes your occupation. |
Sales and Sales Related |
| What is the zip code of your primary workplace/worksite? |
43085 |
| 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 3/24/2020 9:17:00.
Show responses
|
| Timestamp |
3/24/2020 9:17:00 |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Feeling cold, chills or shivers] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Headache] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Aches all over the body] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Cough] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Rapid breathing] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Shortness of breath] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Wheezing or chest tightness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Bluish lips or face] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Dizziness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Confusion or inability to arouse] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Running nose] |
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 22-28 March 2020
|
Responses submitted 3/24/2020 9:21:46.
Show responses
|
| Timestamp |
3/24/2020 9:21:46 |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Feeling cold, chills or shivers] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Headache] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Aches all over the body] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Cough] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Rapid breathing] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Shortness of breath] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Wheezing or chest tightness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Bluish lips or face] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Dizziness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Confusion or inability to arouse] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Running nose] |
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 11:30:29.
Show responses
|
| Timestamp |
3/30/2020 11:30:29 |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Feeling cold, chills or shivers] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Headache] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Aches all over the body] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Cough] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Rapid breathing] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Shortness of breath] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Wheezing or chest tightness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Bluish lips or face] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Dizziness] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Confusion or inability to arouse] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Running nose] |
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 4/6/2020 15:16:27.
Show responses
|
| Timestamp |
4/6/2020 15:16:27 |
| 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 4/13/2020 18:16:13.
Show responses
|
| Timestamp |
4/13/2020 18:16:13 |
| 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 |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
|
Harvard PGP COVID-19 Health Assessment [Ongoing]
|
Responses submitted 6/12/2020 12:26:32.
Show responses
|
| Timestamp |
6/12/2020 12:26:32 |
| 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 |