[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