COVID-19 Wellness Check Assessment

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Do you or anyone you are living with currently have or recently had any s/s of a flu-like or respiratory infection such as:

Have you experienced any of the following symptoms in the past 48 hours:
  • fever or chills
  • cough
  • shortness of breath or difficulty breathing
  • fatigue
  • muscle or body aches
  • headache
  • new loss of taste or smell
  • sore throat
  • congestion or runny
  • nose
  • nausea or vomiting
  • diarrhea
Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19?
Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19?
Are you currently waiting on the results of a COVID-19 test?
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