Moving EverestStaff COVID-19 Symptom Screener
Email address *
Name *
Phone # *
In the last 24 hours have you experienced any of the following symptoms that you can not attribute to another health condition? Please check all that apply. *
Required
Has anyone in your household been in contact with a confirmed case of COVID-19 within the past 14 days? *
Have you traveled outside of the state in the past 14 days? *
Have you traveled internationally in the past 14 days? *
Have you tested positive for COVID-19 in the past 10 days?
Clear selection
Are you waiting on the results of a COVID-19 test? *
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