Condition How often do you suffer from it? select an option... occasionally continuously almost every day every day a few times per day almost every week every week a few times per week almost every month every month a few times per month almost every year every year a few times per year unknown frequency My condition is not on the list... In this case, the field above is no longer required. Please fill the required field below. Condition Other known names TIP: Use a comma to separate each name. Were you tested for the virus? select an option... Yes, result was positive Yes, result was negative No, no test done Were you under quarantine or in the hospital? select an option... For a month or more For a few weeks For a few days At a specific location At home Self-quarantined Neither hospital nor quarantine At home to minimize spreading Described in the notes below Notes on quarantine or hospitalization...
Tell us a bit about your condition... TIP: You can use bold and italic in your text like this **bold** and _italic_.
Does your condition affect your mood? (e.g. does it make you angry, afraid, upset, gloomy, etc.) Any notes about your choice?
