First and last name: (If there's part of your identity that you'd like to anonymize, please indicate here.) *
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When did you try to get tested for the coronavirus? (Please provide an exact date. If you tried multiple times, please list all the dates on which you sought testing.) *
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In what city or cities did you try to get tested? *
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In what state? *
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What was the name(s) of the doctor’s office, clinic, hospital, etc. where you tried to get tested? *
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Had you traveled to another country or state prior to seeking testing? If so, where?
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What were your symptoms? *
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Were you ultimately able to get tested? *
If you've been tested, what was the result?
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Briefly describe what happened when you tried to get tested. If you were denied a test, please describe any explanation you were given. *
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If you were denied testing, what have you done since then? Have you tried to request a test again, self-quarantined yourself, etc.?
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How have your symptoms progressed?
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