COVID-19 Risk Assessment Questions

  1. Have you/Has the patient been diagnosed with, tested for, or suspected of having COVID-19?
  2. In the last 14 days, have you/has the patient had close contact with a person who is diagnosed with or suspected of having COVID-19?
  3. In the last 14 days, have you/has the patient traveled internationally?
  4. Are you currently or have you in the past 14 days experienced any of the following symptoms:
    • Fever
    • Cough
    • Sore throat
    • Shortness of breath
    • Difficulty breathing
    • Chills
    • Muscle pain
    • Headache
    • GI symptoms
    • New loss of taste or smell