COVID-19 Safety Questionnaire
1 of 3: Has anyone who will be visiting the clinic experienced any of following symptoms in the past 48 hours?
- Cough
- Headache
- Muscle aches
- Loss of taste/smell
- Chills
- Sore throat
- Temp > 100F
- Runny nose
- Trouble breathing
- Diarrhea
- Nausea