Have you come in close, regular contact (within 6 feet) of someone who has a laboratory confirmed COVID-19 diagnosis within the past 14 days? *
Do you have any of the following: fever or chills, cough, shortness of breath or difficulty breathing, body aches, headache, new loss of taste or smell, sore throat? *
Have you traveled to any of the states on currently on the Advisory List in the last 14 days? *
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This form was created inside of Diocese of Rockville Centre. Report Abuse