Have you experienced a fever of 100.4F or greater in the past 14 days? *
Required
Have you received a positive result from a COVID-19 test within the past 14 days? *
Required
Have you been in contact with anyone while they had COVID-19 or symptoms of COVID-19 in the past 14 days? *
Required
In the past 14 days, have you, or someone you have been in contact with traveled outside your state/province/country or to an area currently on the NY State travel restriction list? *
Required
In the past 14 days, have you experienced any of the following new symptoms not attributed to another health condition? Select all that apply? *