Florida Elite COVID-19 Screening Questions
Must be answered by each family in entirety prior to entering the facilities
Name: *
Phone: *
Have you or anyone in your household traveled internationally in the last 14 days? *
Have you or anyone in your household traveled domestically in the past 14 days to any regions experiencing widespread community of Covid-19? For more information, visit https://wwwnc.cdc.gov/travel/notices/warning/coronavirus-global *
Have you or anyone in your household been in direct contact with a person who has been diagnosed with Covid-19 or is displaying any of the symptoms of Covid-19? *
Do you or anyone in your household have any of the symptoms of Covid-19 infection? *
Yes
No
Fever
Cough
Shortness of breath
Recent loss of smell and/or taste
Muscle Aches
Shaking chills
Are you or anyone in your household awaiting test results or have received a diagnosis of Covid-19? *
Have you or anyone in your household been asked to directed to self-monitor at home by a medical professional? *
All of these answers are true and correct to the best of my knowledge. *
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