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New COVID Registry
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* Indicates required question
On what day did your new symptoms begin?
*
MM
/
DD
/
YYYY
What are your symptoms?
*
Fever
Loss of smell/taste
Muscle aches
Profound weakness
Cough
Shortness of breath
Sore throat
Burning/tightness in chest
Headache (not explained by anything else)
New onset diarrhea or vomiting (not explained by anything else)
Chills/shaking
Other:
Required
Have you previously had symptoms of COVID?
*
Yes
No
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