Covid-19 Screening Questionnaire

Questionnaire for COVID-19 screening provided by Igbinedion University is below shown. Kindly provide the required information in the questionnaire.

[A] Biodata.

4a. STUDENTS

Department:……………………………………………………………………
Level:……………………………………………………………………………………

4b. STAFF

Department:……………………………………………………………………
[B] SIGNS, SYMPTOMATOLOGY, TRAVEL AND MEDICAL HISTORY:
10. In the last 2weeks what has been your exposure to someone confirmed with COVID-19?
13. If yes to question 12, how many weeks ago?.............................................................................
15. What treatment modality did you utilize?
17. Do you have any of these medical conditions? Please tick as much as it applies to you?