Symptoms and Exposure Checklist
For attendees with chronic conditions, a positive screening should represent a change from their typical health status.
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Email *
Do you currently have any of the following symptoms:
- Temperature 99.6 degrees Fahrenheit or higher when taken by mouth
- Sore throat
- New uncontrolled cough that causes difficulty breathing (for individuals with chronic allergic /asthmatic cough, a change in their cough from baseline)
- Diarrhea, vomiting, or abdominal pain (including stomach aches)
- Shortness of breath, difficulty breathing, or painful breathing
- Fatigue (including tiredness)
- Muscle or body aches
- Loss of taste or smell
- New onset of severe headache  *
Have you had close contact with a person with confirmed Covid-19; close contact defined as any of the following:
- being directly exposed to infectious secretions including being sneezed, coughed, or somehow getting respiratory droplets on oneself
- being within 6 feet of someone for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated (whether or not either party was wearing masks)
- providing care to the person at home
-having direct physical contact with the person (e.g., hugged or kissed them)
-having shared eating or drinking utensils
-living in the same household (e.g., roommates, family members) 
-having shared transportation with the person (e.g., car ride)
 *
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