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COVID-19 Screening COVID-19 Screening Patient First Impatient Last NameDatePLEASE READ EACH QUESTION CAREFULLY Have you experienced any of the following symptoms in the past 48 hours: (Please choose the answer(s) that applies to you) Fever or chillsCoughCongestion or runny noseShortness of breath or difficulty breathing Nausea or vomitingFatigueNew loss of taste or smellDiarrheaSore throatNoneWithin the past 14 days, have you been in close physical contact (6 feet or closer for at least 15...
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Read the questions carefully and answer truthfully.
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Provide personal information such as name, contact details, and date of birth.
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Answer questions about symptoms (if any), recent travel history, and contact with infected individuals.
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Covid-19 screening questions are used to assess an individual's risk of having or being exposed to the virus.
Employers, schools, and other organizations may require individuals to fill out covid-19 screening questions.
Individuals can fill out covid-19 screening questions online, on paper forms, or through designated apps.
The purpose of covid-19 screening questions is to identify potential cases early, prevent the spread of the virus, and protect others.
Information such as symptoms, recent travel history, and contact with confirmed cases may be required on covid-19 screening questions.
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