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COVID-19 Questionnaire

Are you at risk?

Do you have a fever AND respiratory symptoms like cough or shortness of breath?

  • If No, you do not have COVID-19 and do not require testing.
  • If Yes, continue:

Have you had close contact with a person infected with COVID-19 or history of travel to an affected geographic area?

  • If No, this is not likely to be COVID-19. If you are otherwise well, self-care at home is advised. If you have other underlying health issues, are immunosuppressed, or feel very ill, you should seek care.
  • If Yes, continue:

Are you over 65, pregnant, or have a chronic lung condition, heart disease, diabetes, or on an immune suppressive medication?

  • If Yes, you should seek medical care. Follow Clinic/Emergency Visit instructions below regarding options for care.
  • If No, continue:

Are you having difficulty breathing, unable to eat or drink, or too weak to care for yourself?

  • Yes, you should be seen. Follow Clinic/Emergency Visit instructions below.
  • No, we recommend home care (rest, Tylenol and time). Avoid contact with other people until two days after you no longer have a fever and are recovering. If you would like to consult with a provider, please call our office. 

Practice Hand Hygiene and Respiratory Etiquette

  • If you do leave your home to go to a care facility, wear a mask so your coughs and sneezes are less likely to infect others. (Masks are NOT recommended for healthy people in the general population.)
  • Wash your hands thoroughly (for at least 20 seconds) after sneezing, blowing your nose, coughing or using the bathroom, and before preparing or eating food.
  • If you cough or sneeze, do so into the bend of your elbow, not your hand. Or use a tissue, and then throw it away immediately afterward.
  • At home, clean often-touched surfaces such as doors and doorknobs, cabinet handles, bathroom hardware, tabletops, phones, tablets and keyboards regularly with disinfectant.

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