Answer clarifying questions

Do you have at least one of these symptoms?
- chest pain or pressure
- severe breathing difficulties
- severe dizziness and disorientation

Yes

No
Your gender

Male

Female

Other/Do not wish to disclose
Your age
Describe your well-being

High temperature

Dry cough

Loss of taste or smell

Blue lips or fingers

Shortness of breath

Headache

Muscle pain

Sore throat

Fatigue

Chills

Conjunctivitis

Diarrhea, nausea

Swollen fingers

Nasal congestion

Sneezing

Relief after antihistamines

None of the above
Do you have chronic and other diseases?

Cardiovascular diseases

Diabetes

Lung disease or asthma

Hypertension

Cancer

Kidney disease

Obesity

COPD

Neurological disorders

Spleen diseases

Liver disease

HIV or AIDS

Immune system diseases

Dementia or predisposition to dementia

Taking medicines that lower immunity

None of the above
Hold your breath for 20 seconds and describe your feelings:

It was easy for me

Discomfort appeared: cough or heaviness / pain in the chest
Do you have new skin rashes?

No

There are chronic skin diseases established by a doctor more than 2 months ago

Dryness and / or itching after an antiseptic, gloves or masks

A new rash on the extremities or the body of a red-purple / cyanotic / pink color

Spot hemorrhage or swelling in the feet, fingers, or interdigital spaces

The rash does not disappear when pressed or disappears barely (does not fade)

The rash disappears when pressed completely (turns pale), but after that it becomes bright again

Painful rashes / hemorrhages, joint pain

Rash, fever above 37.3 ° C, swollen lymph nodes

Mesh leg pattern in purple / pink

Insect bites

Other
Optional. Upload a photo of the skin area on which the rashes were found.
Hold the camera 10 cm away.
The photo should contain only skin without other objects.
Ensure good light and no picture blur.

Upload a snapshot