Tohoku University Graduate School of Dentistry form for novel coronavirus disease report
※The contents which you report will be shared with the task force of Tohoku University Graduate School of Dentistry.

【When your report is needed:】
1.When you are suspected of having been infected with the novel coronavirus
  ① When a housemate has been infected with it
            (reacting positively to a PCR test or antigen test)
  ② When you have already called the call center of Miyagi Prefecture or Sendai City
           and received instructions from it
  ③ When you have already visited a medical institution following instructions
           from the call center
  ④ When you are recommended to take a PCR test or other test by a medical institution
            (not via any call center)
2.When you have already been judged as being in close contact with an infected person
      or you have had contact with them, even though not close contact
3.When you have already taken a PCR or antigen test
Sign in to Google to save your progress. Learn more
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of 国立大学法人東北大学. Report Abuse