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Effects of Covid-19 On Mental Health in Croydon
1.
General Health Questions
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1.
Question 1.
On a scale of 1-10 how concerned are you of contracting Covid-19?
(1- Not concerned, 10- Very concerned)
1 to 10.
1
Clear
Please tell us why you gave this score
This is required
2.
Question 2.
On a scale of 1-10 how concerned are you to go back to school or work?
(1- Not concerned, 10- Very concerned)
1 to 10.
1
Clear
Please tell us why you gave this score
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3.
Question 3.
Do you have a pre-existing physical health condition that may be affected by Covid-19?
Yes
No
If yes, please tell us more
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*
4.
Question 4.
Are you, or someone you are supporting in a shielded group?
Required
- Required.
Yes
No
Please state your/their condition
This is required
5.
Question 5.
If you were experiencing symptoms of Covid-19 such as having a cough or fever would you know what to do?
Yes
No
Don't know
6.
Question 6.
During the Covid 19 crisis, have you needed to contact health services for any help or advice?
Yes
No
Please tell us your experience of this
This is required
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