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COVID-19 Questionnaire Adult Alternate Vermiform C19aAV Page 1 of 8ECHOwide Cohort Version 01.31 / April 10, 2020COHORT IDS ITE PARTICIPANT IDPINCOHORT VISIT ID__ __ __ __ ____ __ __ _______ __ _____ECHO

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How to fill out covid-19 questionnaire adult alternate

01

Obtain a copy of the covid-19 questionnaire for adults.

02

Read the instructions provided on the questionnaire carefully.

03

Fill out all the required personal information such as name, date of birth, contact information, etc.

04

Answer all the questions related to your health status, recent travel history, and potential exposure to covid-19.

05

Make sure to be honest and accurate in your responses.

06

If you have any doubts or need assistance, don't hesitate to ask for help from a healthcare provider or a trusted individual.

07

Review your completed questionnaire before submitting it.

Who needs covid-19 questionnaire adult alternate?

01

Adults who are unable to fill out the standard covid-19 questionnaire due to language barriers or accessibility issues may need an alternate version of the questionnaire. For example, individuals who speak a different language or have visual impairments may require a translated or accessible format of the questionnaire.

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What is covid-19 questionnaire adult alternate?

The Covid-19 questionnaire adult alternate is a form that adults can fill out to report any symptoms, exposure, or travel related to Covid-19.

Who is required to file covid-19 questionnaire adult alternate?

Any adult who has symptoms, exposure, or travel related to Covid-19 is required to fill out the questionnaire.

How to fill out covid-19 questionnaire adult alternate?

To fill out the Covid-19 questionnaire adult alternate, adults can provide accurate information about their symptoms, exposure, and travel history related to Covid-19.

What is the purpose of covid-19 questionnaire adult alternate?

The purpose of the Covid-19 questionnaire adult alternate is to help track and prevent the spread of Covid-19 by identifying individuals who may have been exposed to the virus.

What information must be reported on covid-19 questionnaire adult alternate?

Information that must be reported on the Covid-19 questionnaire adult alternate includes symptoms, exposure, and travel history related to Covid-19.

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