Greater Prince William Area: COVID-19 testing survey

The purpose of this survey is to get a picture of COVID-19 illness and testing in our community. Please take the survey only once. Thank you!

Question Title

1. Today's date (Required.)

Please enter date

Date

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2. Your zip code (Required.)

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3. Have you had/are you currently experiencing signs and symptoms of COVID-19? (this could include fever, cough, difficulty breathing, chills, uncontrollable shaking, muscle pain, sore throat, headache, and loss of taste or smell) (Required.)

Yes

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4. Did you contact a medical provider about your symptoms? (Required.)

Yes

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5. Regardless of symptoms, have you been tested for COVID-19? (Required.)

Yes

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6. If you got tested for COVID-19, what were your results? (Required.)

Positive

Negative

I did not get tested

Thank you for taking this survey! Your results will allow us to better understand COVID-19 illness and testing in our community. For more information about COVID-19, please visit vdh.virginia.gov/coronavirus/ or call the Prince William Health District Call Center at (703) 872-7759.

Greater Prince William Area: COVID-19 testing survey

Question Title

* 1. Today's date (Required.)

Question Title

* 2. Your zip code (Required.)

Question Title

* 3. Have you had/are you currently experiencing signs and symptoms of COVID-19? (this could include fever, cough, difficulty breathing, chills, uncontrollable shaking, muscle pain, sore throat, headache, and loss of taste or smell) (Required.)

Question Title

* 4. Did you contact a medical provider about your symptoms? (Required.)

Question Title

* 5. Regardless of symptoms, have you been tested for COVID-19? (Required.)

Question Title

* 6. If you got tested for COVID-19, what were your results? (Required.)

1. Today's date (Required.)

2. Your zip code (Required.)

3. Have you had/are you currently experiencing signs and symptoms of COVID-19? (this could include fever, cough, difficulty breathing, chills, uncontrollable shaking, muscle pain, sore throat, headache, and loss of taste or smell) (Required.)

4. Did you contact a medical provider about your symptoms? (Required.)

5. Regardless of symptoms, have you been tested for COVID-19? (Required.)

6. If you got tested for COVID-19, what were your results? (Required.)