This eight-question form collects post-discharge health data from patients who have recently left hospital and received a COVID-19 vaccine. It opens by capturing full name and primary contact number so the care team can identify and reach the respondent, then records the hospital discharge date and latest vaccine dose date to anchor the health timeline. The "Are you currently experiencing any of the following symptoms?" question presents twelve specific options — from fever and cough to new loss of taste or smell — giving clinicians a structured symptom picture, while the "How would you describe your general well-being today?" question adds a quick overall self-assessment. Two closing questions invite the patient to flag any other adverse reactions in their own words and to say whether they need further medical follow-up. After submitting, patients see a confirmation screen thanking them and noting that their responses support both their ongoing care and public health monitoring.
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They rely on the discharge date and vaccine date questions to correlate any reported symptoms or well-being changes with the correct point in the patient's recovery.
They use the structured symptom options in the "Are you currently experiencing any of the following symptoms?" question to track post-vaccination symptom patterns across a patient population.
They depend on the "Do you require any further medical assistance or follow-up at this time?" question and the contact number collected at the start to prioritise and action follow-up calls.
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