Survey 1 | AlohaTrace | Hawaii Community Effort to Combat COVID-19

Glad you're feeling okay.

Question 1 of 5
Q1. Which of the following best describes you:
- I’m good, thanks!
- I may have been exposed to COVID-19, but feel fine.
- I tested positive for COVID-19, but feel fine now.
- I tested positive for COVID-19, have been medically cleared and feel fine now.

Glad you're feeling okay.

Question 4 of 5
Did you go anywhere the past two days?
- See family/friends
- Doctor/Hospital
- Beach/Park
- Grocery/Drug Store
- Pickup food
- Work
- Other
- No, just stayed at home
Family And Friends Location
Street City Zip Code

Please list the neighborhood city and zip code of the family and friends house you visited.
Medical Location
Medical Building City Zip Code

Please list the medical building, city and zip code of the doctors/hospitals you have been to.
Beach Park Location
Beach/Park City Zip Code

Please list the beach/park, city and zip code of the locations you have been to.
Grocery/Drug Store Location
Store Shopping Center City Zip Code

Please list the store name, shopping center (if known), city and zip code of the stores you have been to.
Food Location
Name Shopping Center City Zip Code

Please list the name, shopping center (if known), city and zip code of the food location you visited.
Work Location
Name Street City Zip Code

Please list the company, street, city and zip code of the work location you visited.
Other Location
Location Street City Zip Code

Please list the location name, neighborhood city and zip code you have been to.

Street	City	Zip Code

Medical Building	City	Zip Code

Beach/Park	City	Zip Code

Store	Shopping Center	City	Zip Code

Glad you're feeling okay.