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Covid-19 Questionnaire for Visitors

Contact Information
Question 1 Definitions:

Fever and/or chills
Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher

Cough or barking cough (croup)
Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have)

Shortness of breath
Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have)

Decrease or loss of taste or smell
Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have

Muscle aches/joint pain
Unusual, long-lasting (not related to getting a COVID-19 vaccine in the last 48 hours, a sudden injury, fibromyalgia, or other known causes or conditions you already have)

Extreme tiredness (18 and over)
Unusual, fatigue, lack of energy (not related to getting a COVID-19 vaccine in the last 48 hours), depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have)

Nausea, vomiting and/or diarrhea  (17 years of age or under)
Not related to irritable bowel syndrome, anxiety, menstrual cramps, or other known causes or conditions you already have

1. Are you currently experiencing any of these symptoms?

Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.


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