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RTHM New Patient
Eligibility Screen
6
Questions
START
1
Did you develop new symptoms during or after COVID-19 infection or COVID-19 vaccination that have lasted more than 4 weeks?
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Yes
No
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2
Are you age 16 or older?
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3
Are you located in California, Oregon, Washington, Florida, or Arizona USA?
*
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Yes
No
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4
Do you have active health insurance that covers labs, routine, and emergency care at your location in your state of residence?
*
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Yes
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5
Do you have a primary care provider who you have seen in the past 6 months?
*
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Yes
No
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6
Do you feel comfortable having medical conversations in English without a translator?
*
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Yes
No
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