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Reappointment Survey/Questionnaire Patient Name: Appointment Date: Screening Date: Have you recently traveled: Outofstate?YES Internationally?YES Noon a cruise ship?YES Mohave you received notice
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How to fill out use this covid-19 screening

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To fill out and use the COVID-19 screening, you must follow these steps:
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Start by answering the provided questions honestly and accurately.
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Fill in your personal information, such as your name, contact details, and any relevant medical history.
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Review your responses to ensure they are correct and complete.
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Submit the screening form either electronically or as instructed.
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Follow any additional instructions provided based on your screening results.
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Continue to monitor your health and follow recommended safety guidelines, even if you pass the screening.

Who needs use this covid-19 screening?

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Anyone who wants to assess their risk and determine if they should take necessary precautions or seek medical advice related to COVID-19 needs to use this screening tool.
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It can be used by individuals, healthcare professionals, and organizations to screen individuals for potential exposure or symptoms associated with COVID-19.
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It is particularly useful for workplaces, schools, and other institutions to ensure the safety and well-being of their employees, students, or members.
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By using this screening tool, individuals can make informed decisions about their health and contribute to preventing the spread of COVID-19.
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The COVID-19 screening is a process designed to assess individuals for symptoms and risk factors associated with COVID-19 infections.
Individuals traveling, attending large gatherings, or required by certain employers or institutions may be mandated to complete COVID-19 screenings.
To fill out the COVID-19 screening, provide personal information, answer health-related questions regarding symptoms and exposure, and submit the form as directed.
The purpose of the COVID-19 screening is to identify individuals who may have been exposed to the virus and to prevent its spread.
Information to report includes personal identification details, current health status, recent symptoms, and possible exposure to COVID-19.
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