Thank you for your interest in the Long COVID registry!

Please take a few moments to complete the steps below; it may take about 5 minutes to read and complete this form.
If you agree to participate, you will hear about research related to Long COVID for which you may qualify.

Should you wish to think about this further, feel free to visit us later at:

If you have already completed this form and need to make changes or want to confirm your submission, please email .


To learn more about Long COVID, also known as long haul or Post COVID-19, please go to the WHO website:

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