Transcription of CDC FACILITIES COVID-19 SCREENING
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CDC FACILITIES COVID-19 SCREENING
1 of 4CS326233-DSTOPTODAY S DATE: _____PLEASE READ EACHQUESTION CAREFULLY1. Regardless of your vaccination status, have you experienced any of the symptoms in the list below in the past 48 hours? IMPORTANT: ANSWER YES EVEN IF YOU BELIEVE THE SYMPTOM(S) IS BECAUSE OF SOME OTHER MEDICAL CONDITION (FOR EXAMPLE, ANSWER YES IF YOU HAVE A RUNNY NOSE BECAUSE OF ALLERGIES).2. Are you isolating or quarantining because you tested positive for COVID-19 or are worried that you may be sick with COVID-19 ?PLEASE CIRCLE THE ANSWER THAT APPLIESTO YOU AND FOLLOW THE INSTRUCTIONS BASED ON YOUR RESPONSECDC FACILITIES COVID-19 SCREENINGA ccessible version available at fever or chills cough shortness of breath or difficulty breathing fatigue muscle or body aches headache new loss of taste or smell sore
Apr 22, 2022 · (ANSWER QUESTIONS ON PAGE 3) 3A: FULLY VACCINATED3 and UP TO DATE5 with all recommended COVID-19 vaccines, including any booster dose(s) if/when eligible OR Have you RECOVERED FROM A DOCUMENTED COVID-19 INFECTION in the last 3 MONTHS? (ANSWER QUESTIONS ON PAGE 2) 5A: NOT FULLY VACCINATED3 or …
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