Screening Form for SNHD

Southern Nevada Health Department is asking us to screen our clients, please fill out the form below to continue with your appointment.

SNHD Screening
Do you have a new cough that you cannot attribute to another health condition? *
Do you have new shortness of breath that you cannot attribute to another health condition? *
Do you have any two of the following symptoms: Fever (100.4°F or higher), chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell? *
Have you come into close contact (within 6 feet) with someone who has a laboratory-confirmed COVID-19 diagnosis in the past 14 days? *