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COVID-19 Questionnaire Child Teleport Alternate Vermiform C19cAVECHOwide Cohort Version 01.31 / June 8, 2020Page 1 of 6COHORT IDS ITE PARTICIPANT IDPINCOHORT VISIT ID__ __ __ __ ____ __ __ _______

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How to fill out covid-19 questionnairechild self-report alternate

01

Ensure the child understands the questions on the covid-19 questionnaire.

02

Encourage the child to answer each question truthfully and to the best of their ability.

03

Provide assistance or clarification if the child is unsure about any question.

04

Ensure the child signs and dates the form if required.

05

Submit the completed questionnaire as instructed by the relevant authority.

Who needs covid-19 questionnairechild self-report alternate?

01

Children who are required to fill out a covid-19 questionnaire for self-reporting purposes.

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What is covid-19 questionnairechild self-report alternate?

The covid-19 questionnaire child self-report alternate is a form designed for parents or guardians to report the health status and potential exposure of children regarding COVID-19.

Who is required to file covid-19 questionnairechild self-report alternate?

Parents or legal guardians of children who have been in settings where COVID-19 exposure may have occurred are typically required to file the questionnaire.

How to fill out covid-19 questionnairechild self-report alternate?

To fill out the questionnaire, parents or guardians should provide accurate information regarding the child's exposure, symptoms, and health status according to the guidelines specified on the form.

What is the purpose of covid-19 questionnairechild self-report alternate?

The purpose is to collect data to assess the health of children, monitor potential COVID-19 symptoms, and facilitate public health responses.

What information must be reported on covid-19 questionnairechild self-report alternate?

Information that must be reported includes the child's name, age, symptoms experienced, any known exposure to COVID-19, and current health status.

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