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. 2020 Oct 21;9:55. doi: 10.1186/s13584-020-00413-1

Table 1.

The personal demographics questionnaire

1. Gender: male / female / other
2. Age: ___
3. Who lives in your household? spouse / parents / children / siblings / flat mate / alone / other
4. In which hospital do you work? Ein Kerem / Mount Scopus / other
5. What is your position in the hospital? senior doctor / resident / nursing staff / intern / lab worker / clerical staff / general services / technician / physical or occupational therapist / dietician / national service volunteer / nurse aid / volunteer / social worker or psychologist / other
6. In what department do you work? ______________________
7. Are you on a COVID-19 Department team? yes / no / other
8. Are you currently working? working in the hospital / COVID-19 home isolation / at home for other reason (maternity leave, other illness, on work leave without pay ect.)
9. The following are risk factors for COVID-19. Do you suffer from any of them? diabetes / obesity / hypertension / chronic heart disease / chronic lung disease / smoker
10. Have you been in isolation because of the COVID-19? yes / no
11. Have you have been tested for COVID-19? yes / no
12. What were the COVID-19 test result? positive /negative / results not received
13. Did you feel relieved after getting tested? yes / maybe / no
13. Of all of the following, which is of the most concern? getting COVID-19 / infecting family / giving corona to patients / my children are at home when I am in hospital / financial problems / professional burnout / other
14. Of the following, which would make the corona epidemic easier for you? better protective gear / educational solution for my children / psychological support / group support / financial help / other
15. What percentage do you estimate that you already have gotten the corona virus? ______%