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C4R COVID-19 Questionnaire

Collaborative Cohort of Cohorts for COVID-19 Research

PhenX URL:
Resource Type:
Survey/Questionnaire
Availability:
Publicly Available, No Cost
Date Published:
01/01/2021
Date Record Updated:
09/09/2021
Description:
The purpose of this questionnaire is to ascertain data on COVID-19 testing, self-reported COVID-19 diagnoses and hospitalizations, symptoms, recovery, re-infection, and vaccination. It also assesses the impact of the pandemic on access to healthcare, finances, health-related behaviors, social interactions, and mood. This questionnaire can be administered to individuals with no prior COVID assessments as well as those with prior COVID assessments. If prior assessments are available, text is provided to guide the interviewer to gather new information.
Content Adapted From:

Additional Descriptors

  • Administered By:
  • Medical Professional, Researcher or Professional Interviewer, Self, Trained Non-Expert
  • Administration Mode:
  • Online or Mobile App, Paper, Phone Interview
    • Electronic Data Capture (EDC):
    • RedCap
      • Language:
      • Chinese, English, Spanish
        • Resource Type:
        • Survey/Questionnaire
          • Study Population:
          • Age
            • Age: Adult
            • Event Type:
            • Infectious Disease Outbreak
              • Exposure Agent:
              • Biological or Infectious Agent
                • Biological or Infectious Agent: Virus
                  • Virus: SARS-CoV-2, SARS-CoV-1, MERS
                • Special Topics:
                • Community Impacts, Diagnosis or Status or Treatment or Recovery, Symptoms
                  • Risk Reduction Behaviors: Vaccine-related

                Related Resources

                CONNECTS Component Information
                Collaborative Cohort of Cohorts for COVID-19 Research

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