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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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What is use this covid-19 screening?
The COVID-19 screening is a process designed to assess individuals for symptoms and risk factors associated with COVID-19 infections.
Who is required to file use this covid-19 screening?
Individuals traveling, attending large gatherings, or required by certain employers or institutions may be mandated to complete COVID-19 screenings.
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To fill out the COVID-19 screening, provide personal information, answer health-related questions regarding symptoms and exposure, and submit the form as directed.
What is the purpose of use this covid-19 screening?
The purpose of the COVID-19 screening is to identify individuals who may have been exposed to the virus and to prevent its spread.
What information must be reported on use this covid-19 screening?
Information to report includes personal identification details, current health status, recent symptoms, and possible exposure to COVID-19.
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