This questionnaire was developed in an effort to collect information regarding the profile of patients who have suffered from Covid-19 infection. This information will also be part of a research project undertaken by the Biokinetics Association of Namibia to investigate the effect of physical activity on recovery from Covid-19 and the severity of illness amongst Namibians. Your cooperation and consent is appreciated. All information in this research project is treated as confidential.
By continuing this submission you agree to anonymously submit medical details.
Please be honest in order for the research to reflect true results
DOB
Obesity
Blood Clotting
Allergies
Auto-Immune Disease
High Blood Pressure
Inactivity
Cancer
Diabetes
Depression
Stroke
Cholesterol
Pregnancy
Heart Disease
Days
Walking / Jogging
Aerobics
Yoga
Cycling
Gym / Cross training
Pilates
Swimming
Sports
Other: