COVID-19 Health Screening

Have you tested positive for COVID-19 in the last 10 days?


Do you have any of these symptoms that are not caused by another medically-diagnosed condition (such as influenza, allergies, or other chronic condition)?

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • Loss of taste or smell
  • Sore throat
  • Congestion
  • Nausea or vomiting
  • Diarrhea

Within the past 14 days, have you had close contact with anyone who has tested positive for COVID-19?

Close contact is defined as being unmasked within 6 feet for at least 15 minutes of a person who has tested positive for COVID-19.


Within the past 14 days, has a public health or medical professional told you to self-monitor or self-quarantine because of concerns related to COVID-19?