Erie County Health Department
NOMS
Firelands Physician Group

Symptom Collector

Covid-19 Virus

Thank you for visiting the Symptom Collector for the Erie County Health Department in Sandusky, OH. We're working with our local physician groups to collect this data, to give first responders, hospitals, cities, counties, states and health officials an early warning about symptoms you may be experiencing.

With this information, officials can ensure that testing and services are available where the need is greatest. Anyone, anywhere can report their symptoms using a mobile device or computer, all while staying safely at home.

We’ll start by asking for your permission to use the information you give us. Next the system will request your permission to automatically capture your location. Finally we will ask a series of questions about your current symptoms, and give you the option to record yourself coughing if you have a cough.

Thank you for your willingness to help local experts and officials defeat this dangerous virus.

Please Help. Tell us what symptoms you're experiencing so resources can be prioritized where the need is greatest.

1

Please give us your permission to collect and store this data

I agree to allow my information to be used for this research.

To use this tool, you must give us permission to use your data.

2

Please allow us to capture your location so that we can identify hotspots

Yes, include my location.

Please select your zip code.

Please select your county.
required
3

If you include your mobile number or email address, we’ll send you a link so that you can come back and update your symptoms any time. Your contact information will never be sold, rented or exchanged with anyone.

First Name

Last Name

Mobile Phone or Email Address

Primary care physician

Employer (if currently employed)

Would you like to be contacted by the Erie County Health Dept to learn more about our services?
4

Please answer these questions about yourself and your symptoms. All information is optional, but sharing more information helps doctors and officials make better decisions.

Have you been tested for Covid-19 (aka the Coronavirus)?


How long have you had symptoms? days

If you ran a fever, what was your highest temperature? °

Do you currently feel sick?

Do you still have a cough?

Is anyone else in your household feeling sick?

How old are you?

What is your gender?

What is your race?

Do you smoke?

Do you vape?
What are your primary symptoms?
















Do you have any of the following underlying conditions?

















5

Please record yourself coughing

If you are currently experiencing a cough, please click the START button to give us an audio sample of your cough.

The recorder will turn off and your data will be uploaded after 60 seconds or when you click STOP.

60 Second Timer
6

Thank you for submitting your symptoms. You are helping doctors from Firelands Physician Group, NOMS and public health officials from Erie County, Ohio respond to COVID-19.


Please click here to read about how your information is being used and our privacy policy.

How We Use Your Informationclose
Your data is used only to assist local, state and federal government officials and public health professionals to see where new cases of Covid-19 may be starting, so that they can prioritize their testing and medical resources to those places. Your data will never be sold, rented or exchanged with third parties. We do share your symptoms and general location with governments and health officials, but we do not share your contact information or other pieces of information that can identify you individually. We collect your phone or email address only so that you can return and update your symptoms if you wish, but those pieces of information are encrypted and not shared with or made available to anyone. Please contact us with any questions or concerns.
By monitoring symptoms, officials can better understand where to focus their efforts and create an appropriate response.