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You are here: Home / Tech Tank Survey App / TechTank COVID-19 Screener

TechTank COVID-19 Screener

COVID19
Do you have new onset cough? *
Do you have new onset fever? *
Are you short of breath? *
Have you noticed a loss of your sense of smell or taste? *
What is your gender? *
Do you have a chronic medical condition? (i.e. Diabetes, Heart Disease, Immune Compromised) *
Are you pregnant? *
To the best of your knowledge, in the last month, have you had close contact with a person known to have COVID-19? *
Have you been tested for COVID-19? *

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Hope Bussenius is a 2016 Robert Wood Johnson Foundation Clinical Scholars Fellow.

Support for the take2heart initiative was provided by a grant from the Robert Wood Johnson Foundation Clinical Scholars Fellow program.

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2018 Technological Innovation in Clinical Practice Award

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