Pre-Study Health Check

  • The health and safety of our focus group participants are of the utmost importance. Please take a moment to answer these brief questions to verify your personal health and the safety of everyone involved. First, please enter the email address we have on file for you.
  • In the past 10 days, have you experienced any unexplained persistent dry cough? Yes or no?
  • In the past 10 days, have you experienced any unexplained fever? Yes or no?
  • In the past 10 days, have you experienced any unexplained difficulty breathing or shortness of breath? Yes or no?
  • In the past 10 days, have you experienced any unexplained new loss of taste or smell? Yes or no?
  • In the past 10 days, have you experienced any unexplained muscle pain? Yes or no?
  • In the past 10 days, have you experienced any unexplained chills? Yes or no?
  • In the past 10 days, have you experienced any unexplained sore throat? Yes or no?
  • In the past 10 days, have you experienced any unexplained headache? Yes or no?
  • Do you live with someone in the same household, have a spouse/intimate partner, or have you been providing care to someone currently being tested, treated, or diagnosed with COVID-19?
  • Have you been in close contact [meaning spent 10 minutes or more] with any person who has been diagnosed with COVID-19, or have you been notified of any COVID-19 exposure to yourself in the past 10 days?
  • Have you received any COVID-19 vaccinations? Either the first [partially vaccinated], or second dose [fully vaccinated]?