COVID-19 Screening Questions- Insight
In order to prevent the spread of COVID-19, protect our patients and to comply with recommendations by the CDC, please answer the following questions. If you are experiencing any symptoms consistent with COVID-19 or answer ""YES" to any of the following questions, please give us a call so that we can reschedule you or set you up with an online visit.
Email address *
What is your name? *
Have you tested positive for COVID-19? *
Have you had close contact with or cared for someone who is suspicious for or been diagnosed with COVID-19 within the last 14 days? *
3. Have you had any of these symptoms in the last 14 days?
1. Have you traveled out of the country in the last 14 days? *
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