How Corona Aware Are You

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Email *

Question 1 : How confident are you that you could recognize and respond to a potential coronavirus case? *

Very confident

Moderately confident

Somewhat confident

Slightly confident

Not at all confident

Does not apply

Question 2 : Does your workplace have a written plan to respond to a potential coronavirus case? *

Yes

Does not apply

Question 3 : Are you asking your patients with fever and respiratory symptoms if they have recently traveled in China or corona affected areas? *

Yes

Does not apply

Question 4 : Do you know how to send appropriate patient samples to your local public health department for coronavirus testing? *

Yes

Does not apply

Question 5 : How significant of a threat do you think the novel coronavirus poses to your patients? *

Very significant

Significant

Moderately significant

Slightly significant

Insignificant

Does not apply

Question 6 : Which best describes your current work setting? *

Office-based solo practice clinic

Office-based single-specialty group practice

Office-based multispecialty group practice

Hospital

Healthcare organization

Outpatient clinic

Academic (nonhospital), research, military government

Other

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