SCKF COVID Questionnaire
Symptoms: you or anyone in your household, within 10 days prior to the practice:
- fever (over 100.3 degrees)
- cough
- sore throat
- body ache, headache
- nausea, vomiting, diarrhea
- shortness of breath or difficulty breathing
- fatigue
- chills
- nasal congestion
- confusion, brain fog
- loss of taste or smell
Exposure: you or anyone in your household
- currently have COVID-19 or are subject to any specific order to self-quarantine or self-isolate
- had close contact* with anyone with COVID-19 or its symptoms within 10 days prior to the practice
Condition:
- lack of stamina while wearing a mask (e.g. cannot do 50 hayasuburi)
- taking medications to suppress fever, cough, or congestion symptoms
The above will be double checked during sign in for the practice. If you answer yes to any of the above, we will ask you not to participate in the practice.
*Close contact means having been within 6 feet of a COVID-19 positive or symptomatic person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic individuals, 2 days prior to test specimen collection) until the time the individual is isolated, or had direct contact (e.g. being coughed on).