Additional Recommended Covid-19 Questionnaire
 

Please answer the following questions truthfully.

Regardless of your vaccination status, have you recently experienced any of the following symptoms •

• New Loss of Taste or SmellFever or Chills
• Cough
• Shortness of Breath or Difficulty Breathing
• Fatigue
• Muscle or Body Aches
• Headache
• Sore Throat
• Congestion or Runny Nose
• Nausea or Have you been in close physical contact in the last 10 days with anyone who is known to have Covid-19

IMPORTANT: ANSWER “YES” EVEN IF YOU BELIEVE THE SYMPTOM(S) IS BECAUSE OF SOME OTHER MEDICAL CONDITION (FOR EXAMPLE, ANSWER “YES” IF YOU HAVE A RUNNY NOSE BECAUSE OF ALLERGIES).

If you have answered yes to any of these questions, further investigation of infection is recommended.

Utilizing a PCR test is recommended for verification of possible infection.

or contact your health care provider for PCR testing near to you.