The test is anonymous. We do not collect any data.
    The result will be sent to your email.

    Gender
    MaleFemale

    Age:

    Do you come from an area that is the focus of COVID-19 infection?
    A contact is defined as spending more than 15 minutes face-to-face with someone who has been diagnosed as:
    A laboratory-confirmed COVID-19 (Coronavirus) patient/A suspected COVID-19 (Coronavirus) patient
    YesNo

    In the last 14 days before the start of your symptoms, did you travel internationally or to the
    areas where COVID-19 (Coronavirus) is widespread, including cruise ship travel?

    YesNo

    Have you been in contact with people who have traveled to the infected areas?
    YesNo

    Do you currently have nasal congestion (stuffy nose)?
    YesNo

    Do you currently have dry cough?
    YesNo

    Emergency Symptom!
    Do you currently have difficulty breathing?
    YesNo

    Are you wheezing? (Wheezing is a whistling sound made while breathing)
    YesNo

    Do you currently have these symptoms: Achiness/Feeling run-down or sick/Chills/Weakness of the body?
    YesNo

    Do you have a chest pain?
    YesNo

    Do you have a mild temperature?
    YesNo

    Emergency Symptom!
    Do you have a fever >= 37.5oC ?
    YesNo

    Emergency Symptom!
    Do you have confusion?
    YesNo

    Do you feel exhaustion?
    YesNo

    Emergency Symptom!
    Do you currently have these symptoms: Facial pain or pressure/Headache?
    YesNo

    Do you currently have ear pain?
    YesNo

    Do you have a chronic illness?
    YesNo

    Do you have a weakened immune system?
    YesNo

    Do you have diabetes?
    YesNo

    Do you have asthma?
    YesNo

    Do you have a heart disease?
    YesNo

    Do you have a mild throat pain?
    YesNo

    Do you have diarrhea or nausea?
    YesNo

    Is your voice sore?
    YesNo

    Do you have pain in your joints?
    YesNo

    Does pain in joints extends to fingers?
    YesNo

    Is your face / lips bluish (livid)?
    YesNo

    Are you loosing on your appetite?
    YesNo

    Please add any other symptoms / health-related complaints
    or various information about your health status (information
    not listed in the test):

    Date of completion of the test:

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    Please note that the COVID-19 is proven by a physical test that we do not perform online. Thank you.

     


    This test does not provide diagnostic services.

    Using the questionnaire on the site is not equivalent to medical care. If you feel that your health is severely impaired, please seek medical advice immediately.