In the last 5 days (10 if not fully vaccinated), has the patient had any of the following symptoms, that are not related to other known causes or conditions you already have? • Fever and/or chills • Cough • Shortness of breath • Decrease or loss of taste or smell • Muscle aches/joint pain • Extreme tiredness • Runny or stuffy/congested nose • Headache • Nausea, vomiting and/or diarrhea *
