Minneapolis VIBE Health Questionnaire

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Minneapolis VIBE Health Questionnaire

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* Indicates required question

Name *

Your answer

Have you had any new cough? *

Yes

No

Have you had any shortness of breath? *

Yes

No

Have you had a fever? *

Yes

No

Have you had a sore throat? *

Yes

No

Have you had a headache? *

Yes

No

Have you had chills? *

Yes

No

Have you lost the sense of smell or taste? *

Yes

No

Have you had any diarrhea or vomiting within the last 24 hours? *

Yes

No

Have you been in close contact with any person experiencing covid-19 symptoms? *

Yes

No

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