Oshki COVID-19 Self Assessment
To be completed by everyone before entering the office.
Email address *
Please enter your name *
Are you currently experiencing any of these symptoms? Choose any/all that are new, worsening, and not related to other known causes or medical conditions. *
Required
If you answered “YES” to any of these symptoms:
Contact Administration to let them know about this result.
You should isolate (stay home) and not leave except to get tested or for a medical emergency.
Talk with a doctor/health care provider to get advice or an assessment, including if you need a COVID-19 test.
Are you currently experiencing any of these symptoms? Choose any/all that are new, worsening, and not related to other known causes or medical conditions. *
Required
If you answered “YES” to only one of these symptoms:
Contact Administration to let them know about this result.
You should isolate (stay home) for 24 hours and not leave except for a medical emergency.
After 24 hours if your symptom is improving, you can return to work when you feel well enough to go. You do not need to get tested.
If you answered “YES” to two or more of these symptoms:
Contact Administration to let them know about this result.
You should isolate (stay home) and not leave except to get tested or for a medical emergency.
Talk with a doctor/health care provider to get advice or an assessment, including if you need a COVID-19 test.
If the answer is "Yes" to any of the following, check the corresponding box. *
Required
If you answered “YES” to two or more of these symptoms:
Contact Administration to let them know about this result.
You should isolate (stay home) for 14 days and not leave except to get tested or for a medical emergency.
Talk with a doctor/health care provider to get advice or an assessment, including if you need a COVID-19 test.
If you answered “None of the above” to all questions, you may enter the office.
Masks must be worn at all times, over both your mouth and nose.
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