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COVID-19 Health Screening Questionnaire

Please read each question carefully and answer the questions with the correct answer that applies. 

Daily monitoring for potential COVID-19 symptoms is important to track your current health status. If you experience new symptoms, consider seeing your healthcare provider or getting a test for COVID-19, especially where you may have had potential exposures to COVID-19.  


You should also monitor your health and consider consulting your primary care physician after testing positive for COVID-19. 

1. Have you failed the olfactory disorder test or noticed changes in taste or smell?


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