Editable and Fillable documents: do you have a fever, or have you felt hot or feverish recently (within last 2 weeks)?are you having shortness of breath or other difficulties breathing?

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Editable and Fillable documents

  1. Do you have a fever, or have you felt hot or feverish recently (within last 2 weeks)? Are you having shortness of breath or other difficulties breathing?
  2. Do you have a cough? Do you have any other flu-like symptoms such as diarrhea, headache, or fatigue?
  3. Have you experienced loss of taste or smell? Are you in contact with any confirmed COVID-19 positive patients? Have you experienced discoloration of your fingers and toes?