Are you over 18 years of age? * must provide value
Yes
No
Are you over 16 years of age? * must provide value
Yes
No
Are you a Sanford Health patient?* must provide value
Yes
No
Are you a Sanford Health or Good Samaritan Employee working in a South Dakota, North Dakota, or Minnesota location?* must provide value
Yes
No
We would like your permission to communicate with you through email, which might include sending you a copy of the consent form for review prior to the study coordinator contacting you. Email is generally not a secure way to communicate, as there are ways for unauthorized users to access the communication. Email should not be used to convey information of an urgent nature. If you agree to provide and allow use of email, it would be limited to this purpose. We will never ask you to provide sensitive information like your Social Security number over email. * must provide value
I agree to provide my personal email address
I do not agree to provide my personal email address
I'd like a researcher to contact me for my personal email address
I agree to provide my personal email address
I do not agree to provide my personal email address
I'd like a researcher to contact me for my personal email address
Have you been diagnosed with COVID-19? * must provide value
Yes
No
Have you received a positive COVID-19 test within the last 7 days?* must provide value
Yes
No
Did you experience COVID-19 symptoms?* must provide value
Yes
No
Have you had at least one of the following symptoms within the last 48 hours? -subjective fever or feeling feverish -cough -shortness of breath or difficulty breathing at rest or with activity -sore throat -body pain or muscle pain/aches -fatigue -headache -chills -nasal obstruction or congestion -nasal discharge -nausea or vomiting -diarrhea -documented temperature >100.0°F
* must provide value
Yes
No
Has it been at least 14 days since your last symptom?* must provide value
Yes
No
Are you able to provide a printed copy of your positive test result?* must provide value
Yes
No
Are you able to come to Sioux Falls to donate a unit of blood?* must provide value
Yes
No
Are you able to come to Sioux Falls or Fargo for follow-up visits site visits?* must provide value
Yes
No
Are you currently being treated for COVID-19 at home, not requiring hospitalization?* must provide value
Yes
No
(If Female) This study is not currently evaluating pregnant or breastfeeding women, do you plan to refrain from pregnancy or breastfeeding for the next 6 months? * must provide value
Yes
No
N/A
SURVIVE Sanford Research is conducting a study to learn more about the prevalence, duration and rate of acquisition of antibodies to SARS-CoV-2, the virus that causes COVID-19. Participation includes donating blood and completing a survey 7 times (every 60 days) for one year. Do you want to participate in this study?
Yes No I'm already participating in this study Yes
No
I'm already participating in this study
COVID-19 Questionnaire Sub-Study Sanford Research is conducting a study to capture patient-reported data, including symptoms and exposure, allowing researchers to evaluate factors that influence the severity of infection. Participation includes completing a one-time questionnaire which takes approximately 20 minutes to complete. Do you want to participate in this study?
Yes No I'm already participating in this study Yes
No
I'm already participating in this study
ACTIV-2 Drug studies often look at the effect one or two drugs have on a medical condition, and involve one company. Sanford Health is currently partnering in a study to efficiently test multiple drugs from more than one company in people who have tested positive for COVID-19 but who do not currently need hospitalization. This could help prevent disease progression to more serious symptoms and complications, and spread of COVID-19 in the community. Participation includes IV infusion (1), in-person and telephone follow-up visits with the research team (9 total), having blood and nasal swabs collected by the study team (7 total), performing self-collected nasal swabs (17 total). You will also need to complete a study diary every day for the first 28 days. Do you want to participate in this study?
Yes No I'm already participating in this study Yes
No
I'm already participating in this study
BioBank The Sanford Biobank is a free opportunity available to all Sanford Health patients. The Biobank collects and stores blood and/or tissue specimens to be used for any future research purposes, such as COVID-19 research, cancer studies, etc. Your participation is voluntary, and can be withdrawn at any time. Participation includes a one-time blood draw. Do you want to participate in this study?
Yes No I'm already participating in this study Yes
No
I'm already participating in this study
Convalescent Plasma Sanford Health is collecting, processing, and distributing the plasma for treatment in patients with active, serious COVID-19 infections. Participation includes meeting all of the requirements for blood donation, and donating a unit of blood in our Sanford Medical Center Blood Donor Room. Do you want to participate in this study?
Yes No I'm already participating in this study Yes
No
I'm already participating in this study
Please enter your information below and researchers will contact you regarding the COVID-19 Registry / Recovered Blood Collection study. You may be eligible for this study. Please enter your information below and researchers will contact you about the Healthcare Worker Antibody Study. You may be eligible for this study. Please enter your information below and researchers will contact you about the ACTIV-2 / A5401 (COVID-19 positive, Outpatient treatment) Study. You are not eligible for the Registry / Recovered Blood Collection study at this time. If you are diagnosed at a later date, please contact us at that time. You are not eligible for the Healthcare Worker Antibody Study. You are not eligible for the ACTIV-2 / A5401 (COVID-19 positive, Outpatient treatment) Study. Have you been directly exposed to someone with COVID-19? * must provide value
Yes
No
Which study are you interested in?* must provide value
Registry/Recovered Blood Collection
SURVIVE (Healthcare Worker Antibody Study)
ACTIV-2 / A5401 (COVID-19 positive, Outpatient treatment) Study
Registry/Recovered Blood Collection
SURVIVE (Healthcare Worker Antibody Study)
ACTIV-2 / A5401 (COVID-19 positive, Outpatient treatment) Study
We would like your permission to communicate with you through email, which might include sending you a copy of the consent form for review prior to the study coordinator contacting you. Email is generally not a secure way to communicate, as there are ways for unauthorized users to access the communication. Email should not be used to convey information of an urgent nature. If you agree to provide and allow use of email, it would be limited to this purpose. We will never ask you to provide sensitive information like your Social Security number over email. * must provide value
I agree to provide my personal email address
I do not agree to provide my personal email address
I agree to provide my personal email address
I do not agree to provide my personal email address
First Name* must provide value
Last Name* must provide value
Date of Birth* must provide value
M-D-Y
Contact Phone Number* must provide value
ex. 6054441234
If we are unable to reach you, can we leave a message?* must provide value
Yes
No
Which Sanford or Good Samaritan location(s) and department(s) have you worked in since 3/1/2020?
Which region is most convenient?* must provide value
Bismarck
Bemidji
Fargo
Sioux Falls
Other
Bismarck
Bemidji
Fargo
Sioux Falls
Other
You are not eligible for this study. Please call back if you change your mind and would be willing to provide an email address. Personal Email Address* must provide value
Thank you for your participation and continued support of Sanford Research. You are not eligible for any of the current studies.
We will forward this information to the proper researchers and they will contact you as soon as possible. Please note that the researchers may call you from a blocked phone number, as many are working from home using personal phones. Researchers will not ask you for financial information. Expect to receive an email from the study team in the next several days. Please check your junk mailbox if you do not receive it. You can expect to see a MyChart Message inviting you to participate in the BioBank in the next several days. If you do not have a MyChart account, you can expect to receive a packet in the mail in the next two weeks. Studies are continuously being added, please check back periodically.
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