Visitor Health Registration
To prevent the spread of COVID and related viruses, all visitors must fill out this survey to identify what symptoms they have recently had, to preclude allowing infected individuals on campus.

Para evitar la propagación del COVID y otros virus relacionados, todos los visitantes deben diligenciar esta encuesta con el fin de identificar los síntomas que han tenido recientemente y así evitar que haya personas infectadas en el campus.
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Visitor type / Visitante *
Visitor Category
Name *
Name / Nombre
ID Number *
ID Number / Número de Identificación
COVID-19 Control
Indicate whether you have had any of the following symptoms within the last 14 days. / Indique si ha presentado alguno de los siguientes síntomas en los últimos 14 días.
Fever *
Have you had a fever? / ¿Ha tenido fiebre? (38° C / 100.4° F or higher)
Breathing *
Have you had difficulty breathing? / ¿Ha sentido dificultad para respirar?
Cough *
Have you had a recurring cough? / ¿Ha tenido tos persistente?
Taste/Smell *
Have you lost your sense of taste or smell? / ¿Siente que ha dejado de percibir olores y/o sabores?
COVID Contact *
Have you had contact or do you live with anyone with COVID, suspected or confirmed? / ¿Ha tenido contacto, o vive con alguien sospechoso o confirmado de tener COVID-19?
Flu-like Symptoms *
Have you had flu-like symptoms or a runny nose? / ¿Ha tenido congestión nasal?
Sore Throat *
Have you had a sore throat? / ¿Ha sentido dolor de garganta?
Headache *
Have you had a headache? / ¿Ha sentido dolor de cabeza?
Tiredness *
Have you felt unusually tired or a sense of general malaise? / ¿Ha sentido dolor muscular o malestar general?
Conjunctivitis *
Have you had conjunctivitis? / ¿Ha tenido conjuntivitis?
Diarrhea + *
Have you had diarrhea or other digestive disorders? / ¿Ha tenido vómito o diarrea?
Rash *
Have you had a rash? / ¿Ha tenido rash o erupción de piel?
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