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Covid-19
Self Assessment
Are you experiencing any of the following symptoms?
Select...
Cough
Fever
Sore throat
Chest congestion
Loss of smell or taste
Difficulty in Breathing
None of the Above
Have you ever had any one of the following:
Select...
Diabetes
Hypertension
Lung disease
Heart disease
Kidney disease
Asthma
None of the above
Have you travelled outside the State in the last 14 days?
Select...
Yes
No
Which of the following applies to you?
Select...
I have recently interacted or lived with someone who has tested positive for COVID-19
I am a healthcare worker and I examined a COVID-19 confirmed case without protective gear.
None of above.
Submit
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