HFD Daily COVID-19 Assessment
Last Name *
First Name *
Is your fever greater than or equal to 100.4' F *
Are you experiencing any of the following? (That is not a normal symptom you would normally experience) *
Have you lost your sense of smell or taste? *
Have you had close contact with someone who has tested positive for COVID-19? *
I hereby swear all questions were answered to my best ability and I will completely comply with any contact tracing if found to be exposed. *
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