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Take Our COVID-19 Screening Checklist
First Name
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Have you experinced any of the following symptoms within thepast 14 days?
FEVER
COUGH
PAINFUL SWALLOWING
SNEEZING/RUNNY NOSE
DIFFICULT IN BREATHING
LOSS OF SENSE OF TASTE
LOSS OF SENSE OF SMELL
Is it likely that you have come into contact with someone who have travelled to or returned from countries/area with local transmission of COVID-19 within the past 14 days.
YES
NO
Does your work include frequent contact with people who have active local transmission of COVID-19 within the past 14 days?
YES
NO
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