Citizen Science Herbal Medicine Data Gathering for COVID-19
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Patient #
Age Sex (M/F)
Have you been officially diagnosed with COVID-19?
Did you treat yourself/someone else with any herbal medicine/supplement regimen?
Herbal Medicine (HM) #1 Dose of HM #1
Times per Day of Dose of HM #1
HM #2Dose of HM #2
Times per Day of Dose of HM #2
HM #3Dose of HM #3
Times per Day of Dose of HM #3
HM #4Dose of HM #4
Times per Day of Dose of HM#4
Supplement (SUP) #1
Dose of SUP #1
Times per Day of Dose of SUP #1
SUP #2Dose of SUP #2
Times per Day of Dose of SUP #3
Adjunct Therapies (steaming, massage, acupuncture, sauna, sound therapy, etc).
Underlying Health Issues Date Symptoms Began Date of Full Recovery
Date of First Herbal Remedy Treatment
Do you feel that the herbal remedies improved your symptoms?
Hospitalization due to complications?CoughingFeverSore ThroatWheezingRunny NoseHeadacheStomach IssuesAching Body
Other Symptoms
Potential Side Effects from Treaments?
Why did you choose these medicines, intended action of plants/supplements on the body
Where you purchased medicine (N/A if homemade)
Resources you used in treating COVID-19 with herbal medicine (books, blog posts, websites, etc.)
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