I am a patient and I would like to participate in the ongoing research on Long COVID
Once you let us know that you would be interested in participating in the ongoing research, our team would get back to you with more details and proforma for consenting.
Name *
Date when last tested positive for COVID-19 *
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How were you tested for COVID-19
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Phone Number *
Mobile / Landline phone number where our team can reach you
You would be comfortable speaking in *
Required
Email
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