Kick Covid To The Curb - NuGenomics
The study is aimed at understanding Covid-19 better and device methods to prevent severity of symptoms and ultimately defeat the disease.
Each question here has a reason for existence directly linked to the study and we are sharing the reason with you.
We request you to fill this form to the best of you knowledge and help all of us defeat Covid-19.  
Name:  Just so we could address you *
Phone Number: to reach you out to you as part of the research program *
Email Id: Your free genetic report will be sent to you here *
Age: To categorize the impact of age on severity of disease *
Gender *
Height ( in cm): To identify the impact BMI on disease severity *
Weight ( in kg): To identify the impact BMI on disease severity *
Blood Group: Let's us understand if certain blood groups are more susceptible *
Current Address: For our phlebotomist to reach for sample collection. A lost phlebotomist is no use to anyone!! *
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