Have you previously been diagnosed with Covid-19?

Are you considered a vulnerable person (current health conditions such as asthma or other respiratory issues)?

Have you had a documented fever above 100.4 in the last 48 hours?

Do you have a persistent dry cough?

Have you experienced shortness of breath?

Have you experienced any chills?

Do you have a sore throat?

Have you recently experienced a loss of taste/smell?

Have you had any trouble breathing?

Have you experienced any chest pain?

Is there any other issue(s) you would like to report to the medical staff not related to the questions above?