Pre-COVID-19 G.I. History Please enable JavaScript in your browser to complete this form.Date Please Check Any of the Following Conditions that You Have HadAnemiaAnxietyAsthmaAtrial FibrillationAutoimmune DiseaseBleeding DisorderBlood ThinnersCancer: G.I. tractChest PainCOPDColitisColon PolypsConstipationCrohn's DiseaseDiverticulitisGERD-HeartburnHemorrhoid'sHerniaHyperthyroidismIrritable Bowel SyndromeKidney StonesKidney DiseaseLiver DiseasePeptic UlcerPrior to Your COVID Infection Was Your Digestion Normal?YesNoPrior to COVID-19 Did You Experience Any of the Following?Change in AppetiteBelchingGaggingRegurgitationBloatingCough BloodDifficulty SwallowingHeartburnNauseaGas-FlatulenceDiarrheaVomitingAbdominal PainJaundiceConstipationBlood in StoolChange in Bowel HabitsRectal PainSubmit