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!

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* 1. Today's date

Please enter date

Date

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* 2. Your zip code

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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)

Yes

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

Yes

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

Yes

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

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.