NOVEL CORONAVIRUS DISEASE (COVID-19) SCREENING QUESTIONNAIRE
 
 
Have you traveled internationally in the last 14 days by air or cruise ship?
 
Have you been in close contact with another person who has been diagnosed with/under investigation for COVID-19 in the last 14 days?
 

Do you have a fever or temperature above 100.4?
 
 
Do you have a cough, runny nose, sore throat or shortness of breath?

Have you recently lost or had a reduction in you sense of taste or smell
 
Are you awaiting results from a COVID test?
 
Have you followed social distancing guidelines?