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Understanding this survey

The following information that you will supply has three purposes:
1.) To learn about your personal experience with "long-term" COVID-19.

2.) To learn how your Prior Medical History may be linked to your experience with LTC.

3.) In reviewing 1.) & 2.) above, identifying areas of your Medical History that might pose problems for you as a participant with our study, or might pose problems for the study itself (variables that might suggest a need for exclusion from this particular study).

Here we assume you have decided to participate and have already completed the "Long-term" COVID-19 & light intervention: Participant Registration. And if that is not the case, do that next when complete here.

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* 1. Study ID#
For quickly finding your results ...
This has the following format:
QI-initials or pseudonym-Year of birth
For me, that looks like: QI-WJO-1950.
If I was in the Control Group, I’d add a “c” like this: QIc-WJO-1950

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* 2. Name, Initials, or Pseudonym

Whatever you chose, like William, or WJO, or Little Bill

Make it easy, to recall as needed for future use.

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* 3. Race / Ethnicity

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* 4. What is your gender?

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* 5. Enter your Date of Birth (dd/ mm/ yyyy)

Date

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* 6. Enter a Date when you think your COVID illness began. This can be a positive test date, or your best impression about when the infection was transmitted.

Date

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* 7. Are you/ were you before becoming ill, an endurance athlete?

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* 8. - Have you had a positive test (antigen or antibody) for SARS-CoV-2 (Y/N)?

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* 9. - Are you currently asymptomatic (i.e., no apparent illness) (Y/N)?

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* 10. - Have you been vaccinated against this virus (Y/N)?

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* 11. - If yes, which vaccines? (can list like this: Astra-Zeneca x2, Pfizer x1, Moderna x1, for example). If not vaccinated leave blank.

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* 12. - Had a positive test recently for this virus? (Y/N) If so, when?

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* 13. Transmitting your experience with COVID illness...
Use the box below to try to give a summary of that illness. To avoid feeling in any way limited in sharing your history, you can send a more complete emailed version to Info@StudyLTCovid.com

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* 14. Any other ongoing or chronic illness to mention at this time? Comment below or simply enter "None."

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* 15. This particular illness is commonly associated with "self-medication" and which is understandable. No judgement is being made here about that decision. Nevertheless, certain substances, medicines, supplements may impact on results obtained during our study. So, please list below, any such substances which you are currently taking. Some medications need to be continued of course. If others could be stopped, please try to do so at least 7 days before the study's "Day 0." In any case, please list them below.

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* 16. This study is unlikely to generate any urgent findings that should be reported rapidly to participants. Nevertheless, staying in touch with participants and having that be possible in both directions is always a good idea.

We use ZOOM from time to time to communicate. That requires sending you an emailed invitation.

So from our end, reach us through:
Questions@StudyLTCovid.com and/ or +32 475 962408

Don’t hesitate to reach out with any questions or observations that you think should be heard, here below or using the above contact info.

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* 17. Your turn.

And if you feel uncomfortable about providing the following information, don’t. Skip it.

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* 18. Thanks again for your time and effort. Your responses will next be transferred to our primary database. It will greatly simplify transfer of your information to other databases (see the site to know which ones) as the study proceeds. One click beats typing over and over, the same information.

If you'd like a bit more information about the background information and results that lead to our ongoing study at StudyLTCovid.com, have a look at LTCOVID.com to understand how and why we moved in 2020 towards an intervention with light (photobiomodulation) for those still suffering with "long-term" COVID-19.

William O’Neill, MD

PS: Remember to click the button below to avoid losing your responses!

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