COVID-19 Symptom Checker
Chicago Blue RFC
Sign in to Google to save your progress. Learn more
Are you currently diagnosed with or believe you may have COVID-19?
Clear selection
Have you been in contact with a COVID-19 confirmed or suspected case in the previous 14 days?
Clear selection
Have you had any of these symptoms of COVID-19 in the past 14 days?
High temperature (fever):
Clear selection
A new continuous cough:
Clear selection
New unexplained shortness of breath:
Clear selection
If you have answer YES to any of the following questions you should stay at home, inform your medical practitioner, and follow all public health guidance.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy