---
title: COVID-19 Screening Form
product: PDF Generator
description: Download a printable COVID-19 screening form in PDF. Generate editable or prefilled healthcare screening forms from JSON using SurveyJS PDF Generator.
framework: Vue 3
source: https://surveyjs.io/pdf-generator/examples/pdf-healthcare-covid-19-screening-form-template/vue3js
index: https://surveyjs.io/pdf-generator/examples/overview.md
---

# COVID-19 Screening Form (Vue 3)

## Files

### `public/index.html`

```html
<div style="display: flex;">
    <div id="app" style="flex: 1 1 0%; height: 100%; min-width: 0;"></div>
    <div id="pdf-preview" style="flex: 0.7 0.7 0%; display: none">
        <embed id="pdf-preview-frame" type="application/pdf" style="width:100%; height:100%;" />
    </div>
</div>
```

### `src/App.vue`

```html
<template>
    <SurveyComponent :model="survey" />
</template>
<script setup lang="ts">
    import { Model } from "survey-core";
    import { SurveyComponent } from "survey-vue3-ui";
    import "survey-core/survey-core.min.css";
    import { SurveyPDF } from "survey-pdf";
    import "./index.css";
    import { json } from "./json";

    function createSurveyPdfModel (surveyModel) {
        const surveyPDF = new SurveyPDF(json);
        if (surveyModel) {
            surveyPDF.data = surveyModel.data;
            surveyPDF.locale = surveyModel.locale;
            
            
        }
        
        return surveyPDF;
    }
    function saveSurveyToPdf (filename, surveyModel) {
        const pdfDoc = createSurveyPdfModel(surveyModel);
        if (!pdfDoc) return;
    
        pdfDoc.save(filename);
    }
    
    const previewDiv = document.getElementById("pdf-preview");
    const previewEmbed = document.getElementById("pdf-preview-frame");
    let pdfBlobUrl;
    
    function showPdfPreview(surveyModel) {
        if (!previewDiv || !previewEmbed) return;
    
        const pdfDoc = createSurveyPdfModel(surveyModel);
        if (!pdfDoc) return;
    
        pdfDoc.raw("blob").then((blob) => {
            if (pdfBlobUrl) {
                URL.revokeObjectURL(pdfBlobUrl);
            }
            pdfBlobUrl = URL.createObjectURL(blob);
            previewEmbed.setAttribute("src", pdfBlobUrl);
            previewDiv.style.display = "block";
        });
    }
    
    function previewPdf(surveyModel) {
        if (!previewDiv) return;
    
        if (previewDiv.style.display !== "none") {
            previewDiv.style.display = "none";
            return;
        }
    
        showPdfPreview(surveyModel);
    }
    
    const survey = new Model(json);
    survey.showCompleteButton = false;
    survey.navigationButtonsLocation = "topBottom";
    survey.addNavigationItem({
        id: "survey_save_as_file",
        title: "Download PDF",
        action: () => {
            saveSurveyToPdf("surveyResult.pdf", survey);
        }
    });
    survey.addNavigationItem({
        id: "survey_pdf_preview",
        title: "Preview PDF",
        visible: window.navigator.pdfViewerEnabled,
        action: () => {
            previewPdf(survey);
        }
    });
</script>
```

### `src/index.css`

```css
/* You can add your custom CSS here. */
```

### `src/json.ts`

```ts
export const json = {
  "title": "COVID-19 Screening Form",
  "description": "All fields with an asterisk (*) are required fields and must be filled out in order to process the information in strict confidentiality.",
  "headerView": "advanced",
  "pages": [
    {
      "name": "patient-info",
      "title": "Patient Information",
      "elements": [
        {
          "type": "text",
          "name": "first-name",
          "title": "First name",
          "maxLength": 25
        },
        {
          "type": "text",
          "name": "last-name",
          "startWithNewLine": false,
          "title": "Last name",
          "maxLength": 25
        },
        {
          "type": "text",
          "name": "ssn",
          "title": "Social Security number",
          "validators": [
            {
              "type": "regex",
              "text": "Your SSN must be a 9-digit number.",
              "regex": "^\\d{9}$"
            }
          ],
          "maxLength": 9
        },
        {
          "type": "text",
          "name": "birthdate",
          "startWithNewLine": false,
          "title": "Date of Birth",
          "inputType": "date"
        }
      ]
    },
    {
      "name": "page-symptoms",
      "title": "Current Symptoms",
      "elements": [
        {
          "type": "checkbox",
          "name": "symptoms",
          "title": "Have you experienced any of the following symptoms of COVID-19 within the last 48 hours?",
          "choices": [
            "Fever or chills",
            "New and persistent cough",
            "Shortness of breath or difficulty breathing",
            "Fatigue",
            "Muscle or body aches",
            "New loss of taste or smell",
            "Sore throat"
          ],
          "showNoneItem": true,
          "noneText": "No symptoms"
        }
      ]
    },
    {
      "name": "contacts",
      "title": "Contacts",
      "elements": [
        {
          "type": "boolean",
          "name": "contacted-person-with-symptoms",
          "title": "Have you been in contact with anyone in the last 14 days who is experiencing these symptoms?"
        },
        {
          "type": "radiogroup",
          "name": "contacted-covid-positive",
          "title": "Have you been in contact with anyone who has since tested positive for COVID-19?",
          "choices": [
            "Yes",
            "No",
            "Not sure"
          ]
        }
      ]
    },
    {
      "name": "travels",
      "title": "Travels",
      "elements": [
        {
          "type": "boolean",
          "name": "travelled",
          "title": "Have you travelled abroad in the last 14 days?"
        },
        {
          "type": "text",
          "name": "travel-destination",
          "title": "Travel destination (complete this only if you answered 'Yes' to travelling abroad)",
          "description": "If you travelled abroad in the last 14 days, please specify the country or location you visited."
        }
      ]
    },
    {
      "name": "tests",
      "title": "Tests",
      "elements": [
        {
          "type": "boolean",
          "name": "tested-covid-positive",
          "title": "Have you tested positive for COVID-19 in the past 10 days?"
        },
        {
          "type": "boolean",
          "name": "awaiting-covid-test",
          "title": "Are you currently awaiting results from a COVID-19 test?"
        },
        {
          "type": "paneldynamic",
          "name": "emergency-contacts",
          "title": "Emergency Contacts (complete this section if you tested positive, had contact with a COVID-19 positive person, or reported symptoms)",
          "description": "If you have tested positive, reported symptoms, or were in contact with someone who tested positive, please provide emergency contacts. If possible, specify at least TWO contacts.",
          "templateElements": [
            {
              "type": "text",
              "name": "emergency-first-name",
              "title": "First name"
            },
            {
              "type": "text",
              "name": "emergency-last-name",
              "startWithNewLine": false,
              "title": "Last name"
            },
            {
              "type": "text",
              "name": "emergency-relationship",
              "title": "Relationship"
            },
            {
              "type": "text",
              "name": "emergency-phone",
              "startWithNewLine": false,
              "title": "Phone number",
              "inputType": "tel"
            }
          ],
          "templateTitle": "Contact #{panelIndex}",
          "panelCount": 3,
          "panelsState": "firstExpanded",
          "confirmDelete": true,
          "addPanelText": "Add a new contact person"
        }
      ]
    },
    {
      "name": "finalization",
      "title": "Miscellaneous",
      "elements": [
        {
          "type": "comment",
          "name": "additional-info",
          "title": "Additional information"
        },
        {
          "type": "text",
          "name": "date",
          "title": "Date",
          "inputType": "date"
        },
        {
          "type": "signaturepad",
          "name": "signature",
          "startWithNewLine": false,
          "title": "Signature",
          "signatureHeight": "100px"
        }
      ]
    }
  ],
  "questionErrorLocation": "bottom",
  "questionsOnPageMode": "singlePage"
};
```

### `src/main.ts`

```ts
import { createApp } from "vue";
import App from "./App.vue";

const app = createApp(App);
app.mount("#app");
```

### `src/shims-vue.d.ts`

```ts
/* eslint-disable */
declare module "*.vue" {
    import type { DefineComponent } from "vue"
    const component: DefineComponent<{}, {}, any>
    export default component
}
```

### `src/theme.ts`

```ts
export const themeJson = {};
```

### `.eslintrc.js`

```js
module.exports = {
    root: true,
    env: {
        node: true
    },
    extends: [
        "plugin:vue/vue3-essential",
        "eslint:recommended",
        "@vue/typescript/recommended",
        "@vue/prettier",
        "@vue/prettier/@typescript-eslint"
    ],
    parserOptions: {
        ecmaVersion: 2020
    },
    rules: {
        "no-console": process.env.NODE_ENV === "production" ? "warn" : "off",
        "no-debugger": process.env.NODE_ENV === "production" ? "warn" : "off"
    },
    overrides: [
        {
            files: [
                "**/__tests__/*.{j,t}s?(x)",
                "**/tests/unit/**/*.spec.{j,t}s?(x)"
            ],
            env: {
                jest: true
            }
        }
    ]
};
```

### `babel.config.js`

```js
module.exports = {
  presets: ["@vue/cli-plugin-babel/preset"]
};
```

### `package.json`

```json
{
  "name": "surveyjs-library-vue3",
  "version": "0.1.0",
  "scripts": {
    "serve": "vue-cli-service serve",
    "build": "vue-cli-service build",
    "lint": "vue-cli-service lint"
  },
  "dependencies": {
    "core-js": "^3.6.5",
    "tslib": "2.6.1",
    "vue": "^3.4.1",
    "survey-core": "latest",
    "survey-pdf": "latest",
    "survey-vue3-ui": "latest",
    "vue-router": "^4.0.0-0",
    "vuex": "^4.0.0-0"
  },
  "devDependencies": {
    "@typescript-eslint/eslint-plugin": "^2.33.0",
    "@typescript-eslint/parser": "^2.33.0",
    "@vue/cli-plugin-babel": "~4.5.0",
    "@vue/cli-plugin-eslint": "~4.5.0",
    "@vue/cli-plugin-pwa": "~4.5.0",
    "@vue/cli-plugin-router": "~4.5.0",
    "@vue/cli-plugin-typescript": "~4.5.0",
    "@vue/cli-plugin-vuex": "~4.5.0",
    "@vue/cli-service": "~4.5.0",
    "@vue/compiler-sfc": "^3.0.0",
    "@vue/eslint-config-prettier": "^6.0.0",
    "@vue/eslint-config-typescript": "^5.0.2",
    "@vue/test-utils": "^2.0.0-0",
    "eslint": "^6.7.2",
    "eslint-plugin-prettier": "^3.1.3",
    "eslint-plugin-vue": "^7.0.0-0",
    "node-sass": "^4.12.0",
    "prettier": "^1.19.1",
    "sass-loader": "^8.0.2",
    "typescript": "~3.9.3"
  }
}
```

### `tsconfig.json`

```json
{
  "compilerOptions": {
    "target": "esnext",
    "module": "esnext",
    "strict": true,
    "jsx": "preserve",
    "importHelpers": true,
    "moduleResolution": "node",
    "skipLibCheck": true,
    "esModuleInterop": true,
    "allowSyntheticDefaultImports": true,
    "sourceMap": true,
    "baseUrl": ".",
    "types": [
      "webpack-env",
      "jest"
    ],
    "paths": {
      "@/*": [
        "src/*"
      ]
    },
    "lib": [
      "esnext",
      "dom",
      "dom.iterable",
      "scripthost"
    ]
  },
  "include": [
    "src/**/*.ts",
    "src/**/*.tsx",
    "src/**/*.vue",
    "tests/**/*.ts",
    "tests/**/*.tsx"
  ],
  "exclude": [
    "node_modules"
  ]
}
```

## Other Frameworks

- [Angular](https://surveyjs.io/pdf-generator/examples/pdf-healthcare-covid-19-screening-form-template/angular.md)
- [React](https://surveyjs.io/pdf-generator/examples/pdf-healthcare-covid-19-screening-form-template/reactjs.md)
- [jQuery](https://surveyjs.io/pdf-generator/examples/pdf-healthcare-covid-19-screening-form-template/jquery.md)
- [Vanilla JS](https://surveyjs.io/pdf-generator/examples/pdf-healthcare-covid-19-screening-form-template/vanillajs.md)