|
PGP Participant Survey
|
Responses submitted 7/20/2011 19:05:44.
Show responses
|
| Timestamp |
7/20/2011 19:05:44 |
| 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 |
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 |
Yes |
| Enrollment of older individuals |
Yes |
| Enrollment of parents |
Maybe |
| Enrolled relatives [Monozygotic / Identical twins] |
0 |
| Enrolled relatives [Parents] |
0 |
| Enrolled relatives [Siblings / Fraternal twins] |
0 |
| 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? |
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? |
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 |
No |
| Tissue samples from autopsy |
No |
|
PGP Trait & Disease Survey 2012: Cancers
|
Responses submitted 11/4/2014 16:50:24.
Show responses
|
| Timestamp |
11/4/2014 16:50:24 |
| Have you ever been diagnosed with one of the following conditions? |
Non-melanoma skin cancer, Uterine fibroids |
|
PGP Trait & Disease Survey 2012: Endocrine, Metabolic, Nutritional, and Immunity
|
Responses submitted 11/4/2014 16:51:17.
Show responses
|
| Timestamp |
11/4/2014 16:51:17 |
|
PGP Trait & Disease Survey 2012: Blood
|
Responses submitted 11/4/2014 16:51:37.
Show responses
|
| Timestamp |
11/4/2014 16:51:37 |
|
PGP Trait & Disease Survey 2012: Nervous System
|
Responses submitted 11/4/2014 16:52:02.
Show responses
|
| Timestamp |
11/4/2014 16:52:02 |
|
PGP Trait & Disease Survey 2012: Vision and hearing
|
Responses submitted 11/4/2014 16:52:39.
Show responses
|
| Timestamp |
11/4/2014 16:52:39 |
| Have you ever been diagnosed with one of the following conditions? |
Myopia (Nearsightedness), Floaters |
|
PGP Trait & Disease Survey 2012: Circulatory System
|
Responses submitted 11/4/2014 16:53:02.
Show responses
|
| Timestamp |
11/4/2014 16:53:02 |
|
PGP Trait & Disease Survey 2012: Respiratory System
|
Responses submitted 11/4/2014 16:53:17.
Show responses
|
| Timestamp |
11/4/2014 16:53:17 |
|
PGP Trait & Disease Survey 2012: Digestive System
|
Responses submitted 11/4/2014 16:53:53.
Show responses
|
| Timestamp |
11/4/2014 16:53:53 |
| 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 11/4/2014 16:54:18.
Show responses
|
| Timestamp |
11/4/2014 16:54:18 |
| Have you ever been diagnosed with any of the following conditions? |
Urinary tract infection (UTI), Endometriosis, Ovarian cysts |
|
PGP Trait & Disease Survey 2012: Skin and Subcutaneous Tissue
|
Responses submitted 11/4/2014 16:54:35.
Show responses
|
| Timestamp |
11/4/2014 16:54:35 |
|
PGP Trait & Disease Survey 2012: Musculoskeletal System and Connective Tissue
|
Responses submitted 11/4/2014 16:54:59.
Show responses
|
| Timestamp |
11/4/2014 16:54:59 |
|
PGP Trait & Disease Survey 2012: Congenital Traits and Anomalies
|
Responses submitted 11/4/2014 16:55:23.
Show responses
|
| Timestamp |
11/4/2014 16:55:23 |
|
PGP Basic Phenotypes Survey 2015
|
Responses submitted 8/29/2015 12:23:04.
Show responses
|
| Timestamp |
8/29/2015 12:23:04 |
| 1.1 — Blood Type |
A + |
| 2.1 — Left Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
16 |
| 2.2 — Right Eye (Photograph Number) (full-size image: https://goo.gl/XQ2Voh) |
16 |
| 2.3 — Left Eye Color - Text Description |
Brown |
| 2.4 — Right Eye Color - Text Description |
Brown |
| 3.1 — What is your natural hair color currently, when without artificial color or dye? |
brown |
| 3.2 — Hair Color - Text Description |
Brown |
|
Harvard PGP: COVID-19 Demographics Survey
|
Responses submitted 3/25/2020 12:24:15.
Show responses
|
| Timestamp |
3/25/2020 12:24:15 |
| What is the zip code of your primary residence? |
97520 |
| Do have another residence where you spend more than 30 days a year? |
No |
| What is your age (in years)? |
64 |
| 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. |
You are a fraternal (dizygotic) twin or multiple |
| 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. |
Educational Instruction and Library |
| What is the zip code of your primary workplace/worksite? |
97520 |
| Do you have a secondary workplace/worksite where you work more than 30 days a year? |
Yes |
| What is the zip code of your secondary workplace/worksite (where you work more than 30 days a year)? |
97520 |
| 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 3/25/2020 12:29:00.
Show responses
|
| Timestamp |
3/25/2020 12:29:00 |
| 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] |
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] |
Yes |
| 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] |
Yes |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Vomiting] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Abdominal pain] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Diarrhea] |
Yes |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of smell] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of taste] |
No |
| Are you currently experiencing any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Are you currently experiencing any of the following symptoms? [Feeling cold, chills or shivers] |
No |
| Are you currently experiencing any of the following symptoms? [Headache] |
No |
| Are you currently experiencing any of the following symptoms? [Aches all over the body] |
No |
| Are you currently experiencing any of the following symptoms? [Cough] |
No |
| Are you currently experiencing any of the following symptoms? [Rapid breathing] |
No |
| Are you currently experiencing any of the following symptoms? [Shortness of breath] |
No |
| Are you currently experiencing any of the following symptoms? [Wheezing or chest tightness] |
No |
| Are you currently experiencing any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
| Are you currently experiencing any of the following symptoms? [Bluish lips or face] |
No |
| Are you currently experiencing any of the following symptoms? [Dizziness] |
No |
| Are you currently experiencing any of the following symptoms? [Confusion or inability to arouse] |
No |
| Are you currently experiencing any of the following symptoms? [Running nose] |
No |
| Are you currently experiencing any of the following symptoms? [Sore throat] |
No |
| Are you currently experiencing any of the following symptoms? [Nausea] |
No |
| Are you currently experiencing any of the following symptoms? [Vomiting] |
No |
| Are you currently experiencing any of the following symptoms? [Abdominal Pain] |
No |
| Are you currently experiencing any of the following symptoms? [Diarrhea] |
No |
| Are you currently experiencing any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
| Are you currently experiencing any of the following symptoms? [Loss of sense of smell] |
No |
| Are you currently experiencing any of the following symptoms? [Loss of sense of taste] |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
|
Harvard PGP: COVID-19 Health Assessment for Week of 29 March- 4 April 2020
|
Responses submitted 3/30/2020 11:21:32.
Show responses
|
| Timestamp |
3/30/2020 11:21:32 |
| 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] |
Yes |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Wheezing or chest tightness] |
Yes |
| 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] |
Yes |
| 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] |
Yes |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Diarrhea] |
Yes |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of smell] |
No |
| Since Jan 1, 2020, have you experienced any of the following symptoms? [Loss of sense of taste] |
No |
| Are you currently experiencing any of the following symptoms? [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Are you currently experiencing any of the following symptoms? [Feeling cold, chills or shivers] |
No |
| Are you currently experiencing any of the following symptoms? [Headache] |
No |
| Are you currently experiencing any of the following symptoms? [Aches all over the body] |
No |
| Are you currently experiencing any of the following symptoms? [Cough] |
No |
| Are you currently experiencing any of the following symptoms? [Rapid breathing] |
No |
| Are you currently experiencing any of the following symptoms? [Shortness of breath] |
No |
| Are you currently experiencing any of the following symptoms? [Wheezing or chest tightness] |
No |
| Are you currently experiencing any of the following symptoms? [Persistent pain or pressure in the chest] |
No |
| Are you currently experiencing any of the following symptoms? [Bluish lips or face] |
No |
| Are you currently experiencing any of the following symptoms? [Dizziness] |
No |
| Are you currently experiencing any of the following symptoms? [Confusion or inability to arouse] |
No |
| Are you currently experiencing any of the following symptoms? [Running nose] |
No |
| Are you currently experiencing any of the following symptoms? [Sore throat] |
No |
| Are you currently experiencing any of the following symptoms? [Nausea] |
No |
| Are you currently experiencing any of the following symptoms? [Vomiting] |
No |
| Are you currently experiencing any of the following symptoms? [Abdominal Pain] |
No |
| Are you currently experiencing any of the following symptoms? [Diarrhea] |
No |
| Are you currently experiencing any of the following symptoms? [Pink eye (conjunctivitis)] |
No |
| Are you currently experiencing any of the following symptoms? [Loss of sense of smell] |
No |
| Are you currently experiencing any of the following symptoms? [Loss of sense of taste] |
No |
| 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 14:15:04.
Show responses
|
| Timestamp |
4/6/2020 14:15:04 |
| Since Jan 1, 2020, have you been ill with a cold or flu-like illness? |
No |
| Currently are you experiencing ANY of the above list of symptoms? |
No |
| In the past two weeks, have you experienced ANY of the above list of symptoms? |
Yes |
| In the past 2 weeks, which symptoms have you experienced. [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| In the past 2 weeks, which symptoms have you experienced. [Feeling cold, chills or shivers] |
No |
| In the past 2 weeks, which symptoms have you experienced. [Headache] |
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] |
Yes |
| In the past 2 weeks, which symptoms have you experienced. [Wheezing or chest tightness] |
Yes |
| In the past 2 weeks, which symptoms have you experienced. [Persistent pain or pressure in the chest] |
Yes |
| In the past 2 weeks, which symptoms have you experienced. [Bluish lips or face] |
No |
| In the past 2 weeks, which symptoms have you experienced. [Dizziness] |
No |
| In the past 2 weeks, which symptoms have you experienced. [Confusion or inability to arouse] |
No |
| In the past 2 weeks, which symptoms have you experienced. [Running nose] |
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] |
Yes |
| In the past 2 weeks, which symptoms have you experienced. [Diarrhea] |
Yes |
| In the past 2 weeks, which symptoms have you experienced. [Pink eye (conjunctivitis)] |
No |
| In the past 2 weeks, which symptoms have you experienced. [Loss of sense of smell] |
No |
| In the past 2 weeks, which symptoms have you experienced. [Loss of sense of taste] |
No |
| Since Jan 1, 2020, to the best of your recollection,have you experienced ANY of the above list of symptoms? |
Yes |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Persistent high fever of 38°C (100.4°F) or higher, lasting for a day or more] |
No |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Feeling cold, chills or shivers] |
No |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Headache] |
Yes |
| 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] |
Yes |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Wheezing or chest tightness] |
Yes |
| 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] |
Yes |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Diarrhea] |
Yes |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Pink eye (conjunctivitis)] |
No |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of smell] |
No |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of taste] |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
|
Harvard PGP COVID-19 Health Assessment Week 4: 12 April - 18 April 2020
|
Responses submitted 4/16/2020 11:40:12.
Show responses
|
| Timestamp |
4/16/2020 11:40:12 |
| 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? |
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] |
Yes |
| 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] |
Yes |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Wheezing or chest tightness] |
Yes |
| 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] |
Yes |
| 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] |
Yes |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Diarrhea] |
Yes |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Pink eye (conjunctivitis)] |
No |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of smell] |
No |
| Since Jan 1, 2020, to the best of your recollection which symptoms have you experienced. [Loss of sense of taste] |
No |
| Are you regularly taking any of the following medications? Please choose all those that apply. |
None of these medications |
| Have you been tested for coronavirus (COVID-19) by a medical doctor or other official testing service? |
No, I have not tried to get tested |
| In the past 4 weeks, have you been in close contact with a person who has tested positive for coronavirus (COVID-19)? |
No |
| In the past 4 weeks, have you been in close contact with a person who has symptoms consistent with coronavirus (COVID-19) but has not been tested? |
No |
