PMV Long COVID Symptoms Checklist

Long COVID Symptoms Checklist
Welcome to the Long COVID Symptom Checklist

This self-check is designed to help you better understand your symptoms and support conversations with your healthcare team.

This is not a diagnostic tool, and we do not provide medical advice—but if you need help connecting to care, we’re here to support you.

No personal information is required. Your responses are private, and data may be used anonymously to help raise awareness and improve education about Long COVID.
I have read the above information and would like to continue with the Long COVID Symptoms Checklist for informational purposes only.*

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Today's Date

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Date
Email (Required to receive a copy.)*
example@example.com
Date of COVID-19 Diagnosis (optional)

MonthDayYear
Date
Date of First Vaccine (optional)

MonthDayYear
Date
Approximate Date Symptoms Began *

MonthDayYear
Date
Year of birth*
Country*
State or Province
COVID History (This information will facilitate symptom data analysis. Individual responses will not be reviewed or published).

I have had a COVID infection but no vaccine.I have had a COVID infection AND the vaccine.I have had a vaccine but NOT a COVID infection that I'm aware of.I have NOT had a vaccine or COVID but my health has declined since the pandemic.

You have completed the Long COVID Symtpoms Checklist!

After you hit the submit button, check your email for a printable copy of your responses.

Interpretting Your Responses

Long COVID is a cluster of new symptoms that may seem unrelated and are hard to explain or manage without medical intervention and lifestyle changes. Symptoms are caused by the immune system's response to the spike protien in both the virus and vaccine. Symptoms may persist weeks, months or years and could start after weeks or months after the vaccine or infection, regardless of the severity of illness.

Long COVID typically involves multiorgan inflammation, organ dysfunction/failure, or autoimmune conditions with symptoms lasting weeks, months, or even years after COVID-19 illness or the vaccine.

If you have 3 or more of the conditions listed in this screening tool, you may have Long COVID or another post viral syndrome and it is time to talk to your doctor.

If you have had long COVID for 6+ months and you are suddenly experiencing worse symptoms, you may have had a recent mild COVID infection or other virus.

Barriers to Diagnosis and Treatment
- Lack of community awareness of what Long COVID is and why a person's health may be mysteriously deteriorating but they don't look sick.
- Some providers may not be aware of:What Long COVID is.
- How to recognize the clusters of symptoms.
- How to treat the condition.
- Challenges in recognizing when a person has a new or active COVID infection.
- Mild or asymtomtic infections may be missed or mistaken for a cold or allergies.
- Lack of a diagnostic test to identify Long COVID.
- Routine blood tests, diagnostic imaging (X-rays, CT, MRI), and electrocardiograms may be normal, making it difficult to find answers and solutions.
- Lack of a standard treatment protocol to address the underlying cause of the various seemingly nonrelated health issues that develop.
Would you like ProMedView to contact you with information about Long COVID recovery coaching and/or advocacy, services, resources?

Yes, please email me with information.Yes, please text or call me at the phone number below.No thank you, I will email consult@promedview.com when I need more support.
Add your phone number if you prefer a call or text: phone number . Add time zone or the country:Time Zone or Country.

Note: This form is not to be used for urgent issues. If you have an urgent medical or mental health concern, contact your doctor or a health care facility in your area.
Need Support?

ProMedView: Long COVID Health Coaches and Disability Advocates to support you with your recovery and symptom management. Visit www.promedview.com to learn about our services and book a session.

Long COVID Relief The Long COVID doctors at The Wellness Company work on the cutting edge of healthcare to bring affordable and accessible healthcare. Receive lab testing and access both non-pharma and pharmaceutical treatments from Wellness Providers to overcome lingering symptoms caused by COVID-19 infections. Use discount code COVIDCAREGROUP for extra savings on select services and products. Visit TWC to schedule an appointment.

Post-Covid Neurologists: Neura Health’s team of board certified Neurologists can help with headaches or other Post COVID neural complications. Try this program for $1 for the first month through this link to Neura Health.

Our Most Popular Recovery Tools

Formula C  https://www.endourage.com/lp/formulac/558462

Spike Support Formula  This supplement blend was developed by the TWC Chief Medical Board. It contains nattokinase, dandelion root, and key nutrients to support the body's natural immune and detox pathways. Save an additional 10% with discount code COVIDCAREGROUP.

Medical Emergency Kit Be Prepared, Not Scared: Ensure you're ready for any health crisis or medication shortage. No one knows your body better than YOU! Meet with a TWC doctor to get an medication kit with instructions about when and how to use them for contagions and unforseen medical emergencies.  Save an additional 10% with discount code COVIDCAREGROUP.

Resources

Nurse Laney's Long COVID education blog: Practical tips for recovery and symptom management supported by evidence based research.

The covidCAREgroup Recovery Tools featuring products and servcies vetted by our clinical experts for validity & effectivness.

Whatever you do, don't give up.

Millions of people are living full lives with Long COVID and you can too.

NOTE: This form will NOT be reviewed by ProMedView staff. If you have an urgent health issue, contact your primary care physician or go to an emergency room immediately. If you need help figuring out the next steps in your recovery, book a 1:1 session with Nurse Laney at ProMedView.

Thank you for completing the Symtpoms Checklist. Your completed form will be emailed to you as soon as you hit the "SUBMIT" button.

Share the ProMedView "About Long COVID" page or a printed copy of your resules with family, friends or your doctor.

Go to ProMedView About Long COVID for a comprehensive explanation of Long COVID or vaccine injury.

Email non urgent inquiries to consult@promedview.com.

Keep moving, keep breathing!

-Nurse Laney
Disclosure Statement

This checklist is for informational purposes only. ProMedView is not a healthcare provider and does not offer medical advice, diagnosis, or treatment. Submissions will not be reviewed by ProMedView staff for the purpose of creating a treatment plan.

We respect your privacy. Personal identifiers such as name, address, phone number, and date of birth are not collected. Email addresses, if submitted, will not be shared.

Symptom data collected may be used without identifiers by ProMedView and its affiliates for publishing educational content related to Long COVID and population health trends.
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