Daily Check In Survey
Please note that the completion of this survey is a requirement of the Dept of Health
Name *
Surname *
Gender *
Pleaase categorize yourself *
Age *
Temperature today *
Were you in contact with a person with COVID-19 *
Have you experienced any of the following Symptoms?Coughing, sore throat, shortness of breath, loss of smell/taste, etc. *
Submit
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