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COVID-19 v1

ADRCs will need to provide information about local vaccine availability to participants that are interested. The CDC has provided this guidance for residents that are living in long-term care facilities.

Essential Documents

 

Form, English

Form, Spanish

DED

Data Template

COVID-19 Impact Survey, v1
This optional survey captures data on the impact COVID-19 has had on a participant including testing, course of illness, and medical consequences.
PDF
PDF
PDF
PDF

COVID-19 Technology Accessibility Survey, v1
This optional survey captures a participant's preferences regarding remote visits and use of technology.
PDF
PDF
PDF
PDF