Do you have a fever or above normal temperature (100F)? YES
NO
Have you experienced shortness of breath or had trouble breathing? YES
NO
Do you have a dry cough? YES
NO
Do you have a runny nose? YES
NO
Have you recently lost or had a reduction in your sense of smell or taste? YES
NO
Do you have a sore throat? YES
NO
Have you been in contact with with any confirmed COVID‐19 positive patients? YES
NO
Have you tested positive for COVID‐19? YES
NO
Have you been tested for COVID‐19 and are awaiting results? YES
NO
Have you traveled outside the United States by air or cruise ship in the past 14 days?YES
NO
Have you traveled within the United States by air, bus, or train within the past 14 days?YES
NO
NO
Have you experienced shortness of breath or had trouble breathing? YES
NO
Do you have a dry cough? YES
NO
Do you have a runny nose? YES
NO
Have you recently lost or had a reduction in your sense of smell or taste? YES
NO
Do you have a sore throat? YES
NO
Have you been in contact with with any confirmed COVID‐19 positive patients? YES
NO
Have you tested positive for COVID‐19? YES
NO
Have you been tested for COVID‐19 and are awaiting results? YES
NO
Have you traveled outside the United States by air or cruise ship in the past 14 days?YES
NO
Have you traveled within the United States by air, bus, or train within the past 14 days?YES
NO
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