Hunter New England Local Health District

Surveys Surveys
Participant Account for Demo

Weekly Survey

Hello Demo, and thank you for your participation in Flutracking.

Please answer the following questions for yourself and submit.

Participant Survey
For the week of:
Monday, 11 October 2021
Sunday, 17 October 2021
Did you have:
 |  | 
 |  | 
Sore throat?
 |  | 
Runny nose?
 |  | 
Shortness of breath?
 |  | 
Any change in sense of taste or smell?
 |  | 
 |  | 
  Absence From Duties  
Were you absent from work or normal duties due to these symptoms?
 |  | 
Which days did you have off work or interrupted from normal activities?

  Medical Attention  
Did you contact a health professional due to these symptoms?
(including from COVID test centres/drive-through)
From which type of medical service?
(you can select more than one)

If Other, please provide details:
What was the Diagnosis?

  Swab Test  
Did you have a nose or throat swab during the week ending Sunday 17 October?
 |  | 
Have you received the result yet?
 |  | 
What was the result for COVID-19?

What was the result for Influenza?

What was the result for Other Illness?

  COVID-19 Vaccination  
Have you received the 1st dose of a COVID-19 vaccine?
 |  | 
  Flu Vaccination  
Have you received the Annual Flu vaccine in 2021?
 |  |