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Questions marked with a * are required Exit Survey
 
 
* Name of hospital/laboratory centre:
   
 
 
Contact Information
First Name : 
Last Name : 
Phone : 
Email Address : 
 
 
 
* Does your hospital/laboratory centre have test for Zika Virus?
 
yes
 
no
 
 
 
* What kind of test(s) does your hospital/laboratory centre provide?
 
RT-PCR for Zika viral load
 
Serological test for Zika IgM
 
Plaque-reduction neutralization test PRNT
 
Other:______________________
 
N/A
 
 
 
If your hospital/laboratory centre have RT-PCR for Zika viral load, how much is the test fee?
 
 
<500
 
500-800
 
800-1000
 
1000-1500
 
>1500
 
Not N/A
 
 
 
If your hospital/laboratory centre have serological test for Zika IgM, how much is the test fee?
 
<500
 
500-800
 
800-1000
 
1000-1500
 
>1500
 
Not N/A
 
 
 
If your hospital/laboratory centre have  Plaque-reduction neutralization test PRNT , how much is the test fee?
 
<500
 
500-1000
 
1000-1500
 
1500-2000
 
>2000
 
Not N/A
 
 
 
Does your hospital/laboratory centre have mid-trimester scan for fetal microcephaly or intra-cranial calcification?
 
yes
 
no
 
 
 
Does your hospital/laboratory centre have fetal medicine subspecialist for further Zika anomaly serial scan and management?
 
yes
 
no