Coronavirus Infection Risk Self-Assessment Questionnaire (CIRSAQ 4.0)

This CIRSAQ 4.0 is based on the Prevention and Treatments of 2019 Coronavirus Disease Guideline (Fifth Version) released by the National Health Commission of China on 21 February 2020 and relevant medical papers. The results provided are for personal reference only and cannot replace the doctor's diagnosis. This tool is used anonymously and data would be used for research and teaching purposes only.

I am living in Wuhan now, or travelled to Wuhan in the past 2 weeks.

In the past 2 weeks, I lived, studied or worked together, or had any other close contact with a person with fever and cough who came from Wuhan.

My workplace, school or family has at least 2 confirmed cases.

I am having a fever with body temperature higher than 37.3 ℃ (99.1℉)

Now I feel (single or multiple choices) 【Multiple】

I have the following diseases (single or multiple choices) 【Multiple】

My age is (years)

My gender is

I am a doctor or nurse