COVID-19 Education Quiz
Answer these questions to the best of your ability
Sign in to Google to save your progress. Learn more
How old are you?
Clear selection
What would you best describe the place you live?
Clear selection
What race are you?
Clear selection
How much money do you or your parents make in a year?
Clear selection
Do you have an autoimmune disease?
Clear selection
How many hours do you sleep each night?
Clear selection
Do you have diabetes?
Clear selection
Do you have asthma?
Clear selection
Do you smoke? (Cigarettes, Marijuana, etc)
Clear selection
Do you drink alcohol?
Clear selection
How many days per week do you exercise?
Clear selection
How many meals do you eat per day?
Clear selection
When was your last physical/checkup?
Clear selection
Submit
Clear form
This form was created inside of PROSTEM. Report Abuse