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COVID-19 Screening Form
Covid-19 Screening Form
Covid-19 Screening Form
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Do you have a temp of 100 degrees Fahrenheit or higher?
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Do you have a temp of 100 degrees Fahrenheit or higher?
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Have you had close contact or cared for someone with COVID in the past 14 days?
Have you had close contact or cared for someone with COVID in the past 14 days?
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Have you returned from travel outside of the United States by cruise ship or river boat in the past 14 days?
Have you returned from travel outside of the United States by cruise ship or river boat in the past 14 days?
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Have you been directed to self quarantine by a healthcare provider?
Have you been directed to self quarantine by a healthcare provider?
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Have you been directed to self quarantine by the County or State Department of Public Health?
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Have you been directed to self quarantine by the County or State Department of Public Health?
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Have you had COVID in the last 14 days?
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Have you had COVID in the last 14 days?
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