Pre-screening Questionnaire


12 - 64 years of age
Compensation Provided

Contact Information

Please enter your legal name, a valid phone number, and a valid email address where you can be contacted.

Eligibility Questions

Please answer the following questions to determine your eligibility for this study.

Are you at at between 12 and 64 years old?
Have you tested positive for COVID-19 within the last 72 hours?
Do you have at least two of the following symptoms: stuffy or runny nose, sore throat, shortness of breath (difficulty breathing), cough, low energy, tiredness, muscle or body aches, headache, chills or shivering, feeling hot or feverish?
Are you hospitalized due to COVID-19?