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Corona questions test

Your safety and that of our employees are the most important. When you are visiting Erasmus MC as a patient, we ask you to complete a questionnaire in advance by logging in to My Erasmus MC: see https://www.erasmusmc.nl/en/patient-care/my-erasmus-mc.

Are you planning to visit our hospital as a coach or visitor? Then please answer the questions below before visiting:

Question 1: Has COVID-19 been established for you in the last 14 days?

YES > Dial our general number (010) 704 0 704 to contact the (outpatient) clinic where you have an appointment or hospitalization.

Question 2: Is one of the following situations applicable to you?

  • Your partner/household member has COVID-19 or has had it less than 14 days ago.
  • In the last 14 days you have been contacted for a COVID-19 contact study and you have been given quarantine at home.
  • For the last 14 days you have stayed in another country then The Netherlands where at that time code orange/red was applied.

YES > Dial our general number (010) 704 0 704 to contact the (outpatient) clinic where you have an appointment or hospitalization.

Question 3: Have you had one of the following complaints in the last 14 days or has (have) the complaint(s) become worse?

  • fever (measured temperature of 38°C or higher)?
  • coughing?
  • shortness of breath / tightness of the chest?
  • nose cold / pruning / sneezing / runny nose / blocked nose?
  • sore throat?
  • odor loss and/or loss of taste (even without nasal colds)?

YES > Dial our general number (010) 704 0 704 to contact the (outpatient) clinic where you have an appointment or hospitalization.

Question 4: Are 2 or more of the following complaints/situations applicable to you?

  • feeling sick / feverish feeling?
  • fatigue?
  • muscle pain or joint pain?
  • headache?
  • pain behind the eyes?
  • nausea, diarrhea, vomiting?
  • has your household member / partner developed fever and/or tightedness of the chest in the last 14 days?

YES > 2 or more of the above complaints/situations are applicable with me > Dial our general number (010) 704 0 704 to contact the (outpatient) clinic where you have an appointment or hospitalization.

NO > Less than 2 of the above complaints/situations apply to me. > You can simply come to your appointment. Do you have any questions? Visit www.erasmusmc.nl/coronavragen

END OF QUESTIONNAIRE.