Please fill out the questionnaire form below to check if your symptoms are consistent with the CDC Covid 19 guidelines.


If your temperature is over 99.1 degrees Select YES; if not Select NO.

Does your cough sound dry, Select YES; if not Select NO.

Are you feeling tired and out of energy, Select YES; if not Select NO.

Are you having problems breathing, Select YES; if not Select NO.

Are you experiencing a runny nose, Select YES; if not Select NO.

Are you experiencing Headaches, Select YES; if not Select NO.

Are you experiencing a Sore Throat, Select YES; if not Select NO.

Are you experiencing Muscle and Joint Pain, Select YES; if not Select NO.

Are you experiencing a lot of Sneezing, Select YES; if not Select NO.

Are you experiencing a lot of general Coughing, Select YES; if not Select NO.

Are you experiencing itchy eyes, Select YES; if not Select NO.

Are you experiencing a Runny or Stuffy Nose, Select YES; if not Select NO.

Are you experiencing a general feeling of discomfort, illness, or uneasiness whose exact cause is difficult to identify, Select YES; if not Select NO.

Are you experiencing Congestion, Select YES; if not Select NO.