• [For employed persons] How has the COVID-19 outbreak affected you in the past two weeks
• I believe I can protect myself from COVID-19
• In the past two weeks has your family experienced the following as a result of covid-19?
• Have recommendations for socially distancing caused stress for you?
• Which of the following symptoms did you have?
• Avoid going to a faith based gathering such as a church, synagogue, temple or mosque
• Where did you seek care?
• Avoid going out to a restaurant, bar or club
• Avoid visiting with older (60 years +) family members
• For this illness did you seek advice from a healthcare professional?
• How long after your symptoms started did you seek care?
• For this illness, were you tested for influenza?
• Avoid visiting with other older (60 years +) adults such as friends or neighbors
• Presence of underlying conditions
• Is there community spread of COVID where you are living?
• Health insurance type
• Symptom onset date and time
• Age
• BP sys
• BP dias