Mandatory Symptom Check
UCI wants to remind you to take care of your own health and the health of others. In order to enter the Cove, you must attest to the following statement.
The information you submit will be kept confidential and will be destroyed after five days.
If you do not attest to the following statement, you will not be permitted access to the Cove.
FILL OUT THE FORM BELOW
I attest that the statement below is accurate:
* I do not currently have any of the following symptoms:
(If you have chronic conditions (e.g., migraines) and are experiencing symptoms identical to your usual symptoms, do not report those here).
Shortness of breath (new)
Loss of taste or smell
Diarrhea, vomiting or nausea
Other cold symptoms
Please acknowledge below with "No symptoms", or "Showing symptoms"
Please date below
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This form was created inside of University of California, Irvine.