COVID-19 Pre-Screening Questionnaire Form

COVID-19 (Novel Cornoavirus) Pre-Screening Questionnaire

The only way to confirm if you have COVID-19 is to get tested with a kit, and those are in short supply. However, we can work together to help minimize the risks of further spreading COVID-19 (novel cornoavirus). Please fill out this questionnaire to help us understand how we can prepare to serve you.


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