Transcription of PLEASE READ EACH QUESTION CAREFULLY - Centers for …
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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 sm
Feb 22, 2022 · CDC FACILITIES COVID-19 SCREENING Today’s Date PLEASE READ EACH QUESTION CAREFULLY (footnotes can be found on page 5) Proceed to Question 3A, 4A, or 5A, Based on your Vaccination Status: 1. YES Regardless of your vaccination status, have you experienced any of the symptoms in the
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