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Shigella disease investigation questionnaire
The information in this questionnaire will be treated as STRICTLY CONFIDENTIAL We take your privacy very seriously and will ensure that your data is kept secure. For more information, please view the council's privacy notice.
Please enter your unique reference number
Maximum 255 characters
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What date did you start to feel unwell?
What time did you start to feel unwell?
Are you still ill?
How many days were you ill for?
Have you had any of the following symptoms?
With this illness, were you admitted to hospital?
Do you take any drugs, or suffer from a condition that results in you being immuno-suppressed?
