Choose your age group	□22 years old and below □23-35 years old □36 − 50 years old □51-60 years old □Above 60 years old
Choose your gender	□Male □Female □Other
Choose your income group (by monthly income)	□More than P200,000 □P100,000 - P200,000 □P40,000 - P99,999 □P10,000 - P39,999 □Less than P10,000
Current Residence (Region)	[Input geographical region]
Current Residence (Barangay, Municipality/City)	[Input residence address]
Name of (main) healthcare facility where you work (facility can be hospital, community health center, drugstore, clinic, etc)	[Input name]
Location of workplace identified in previous number (Town/city and region)	[Input location]
Type of health worker	□Doctor – Resident/Fellows □Doctor – Specialist □Medical clerk/intern □Nurse □Associate (e.g. aides, helpers, social workers, therapists) □Lab personnel (medical technologist and technician) □Radiology personnel (radiologic technologist) □Health management & support worker (e.g. accountant in hospital, admin personnel, clerical worker) □Pharmacist □Other
Pre-Lockdown Mode of Transport (Primary Mode Used)	[Enter mode]
ECQ Mode of Transport (Primary Mode Used)	[Enter mode]
GCQ Mode of Transport (Primary Mode Used)	[Enter mode]
How was your access (or travel) to healthcare facility impacted during the quarantine since March 2020?	□Not able to access or go to the healthcare facility □Not impacted □Negatively impacted □Positively impacted
How was your access (or travel) to healthcare facility impacted by the reduction in mobility, particularly public transport?	□Not able to access or go to the healthcare facility □Not impacted □Negatively impacted □Positively impacted