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Appendix A: GeoSentinel Questionnaire


This figure  shows the first page of the two-page GeoSentinel questionnaire. It captures general information (e.g., age, sex, country of birth, country of residence, and immigrant status) about the ill traveler as well as recent and past travel history.

Alternate Text: This figure shows the first page of the two-page GeoSentinel questionnaire. It captures general information (e.g., age, sex, country of birth, country of residence, and immigrant status) about the ill traveler as well as recent and past travel history.



This figure shows the second page of the two-page GeoSentinel questionnaire. It captures additional information about the ill traveler, including exposure details (i.e., country of exposure, reason for travel, whether the traveler is an expatriate, clinical setting, patient type, whether the traveler had a pretravel medical consultation, and main presenting symptoms) and primary diagnosis or diagnoses.

Alternate Text: This figure shows the second page of the two-page GeoSentinel questionnaire. It captures additional information about the ill traveler, including exposure details (i.e., country of exposure, reason for travel, whether the traveler is an expatriate, clinical setting, patient type, whether the traveler had a pretravel medical consultation, and main presenting symptoms) and primary diagnosis or diagnoses.



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