Do you have a cough?

Do you have a fever now or have you in the past 14-21 days?

Have you come in contact with any confirmed COVID-19 positive patients in the last 14 days?

Are you experiencing shortness of breath or difficulty breathing?

Are you experiencing other flu-like symptoms, such as gastrointestinal upset, headache, or fatigue?

Have you traveled in the past 14 days to any regions affected by COVID-19? (as relevant to your location)