Screening Form for SNHD

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? *