Do You Have Long Haul COVID Syndrome?

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Quiz Questions

1.
Have you ever had COVID-19 and/or been vaccinated for COVID-19?*
- A.
  Yes
- B.
  No
2.
Do you experience brain fog?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
3.
Are you prone to headaches?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
4.
Do you experience depression and/or anxiety?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
5.
Do you struggle with concentration?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
6.
Do you experience sleep disturbances?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
7.
How often do you have a runny nose?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
8.
How often do you sneeze?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
9.
Do you experience burning or itchy eyes?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
10.
Do you experience shortness of breath?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
11.
Do you have a persistent cough?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
12.
Are you often congested?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
13.
Do you experience muscle aches?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
14.
Do you often feel fatigued or weak?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
15.
Do you experience joint pain?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
16.
Are you in pain during and/or after exercise?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
17.
Do you struggle with basic activities?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
18.
Do you experience heart palpitations?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
19.
Do you experience Raynaud-like symptoms with cold, tingling, or numb fingers, toes, and/or extremities?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
20.
Do you have itchy skin?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
21.
Do you get frequent rashes?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
22.
Are you often bloated?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
23.
Do you experience nausea or vomiting?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
24.
Do you often suffer with diarrhea?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
25.
Do you experience heart burn?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
26.
Do you often experience an upset stomach?
- A.
  Never or hardly ever
- B.
  Occasionally but pretty mild
- C.
  Occasionally and moderate
- D.
  Often but not unbearable
- E.
  Frequent and severe
27.
Which Forum Health Clinic are you interested in receiving more information on?
- A.
  Akron, OH
- B.
  Asheville, NC
- C.
  Austin, TX
- D.
  Bloomingdale, IL
- E.
  Clarkston, MI
- F.
  Coppell, TX
- G.
  Fitchburg, WI
- H.
  Fond Du Lac, WI
- I.
  Greenville, SC
- J.
  Knoxville, TN
- K.
  Modesto, CA
- L.
  Orem, UT
- M.
  Rochester Hills, MI
- N.
  Santa Rosa, CA
- O.
  Tampa, FL
- P.
  West Jordan, UT

Quiz Outcomes

1.
Mild
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The symptoms you have shared indicate a high index of suspicion that you are experiencing mild Long Haul COVID symptoms. Stop Long Haul COVID Syndrome in its tracks.
2.
Moderate
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The symptoms you have shared indicate a high index of suspicion that you are experiencing moderate Long Haul COVID symptoms. Stop Long Haul COVID Syndrome in its tracks.
3.
Severe
Image Source
The symptoms you have shared indicate a high index of suspicion that you are experiencing severe Long Haul COVID symptoms. Stop Long Haul COVID Syndrome in its tracks.

Do You Have Long Haul COVID Syndrome?

Are you suffering from unexplained or lingering symptoms weeks or even months after a COVID-19 infection? Take the quiz to learn if your symptoms could be a sign of Long-Haul COVID Syndrome.

Quiz Questions

Quiz Outcomes