Covid-19 Screening Questions
|
|
Have you received a previous does of any COVID-19 Vaccine?
|
If yes, which manufacturer's vaccine did you receive?
|
How many doeses of vaccine have you received?
• • •
|
If Yes, When did you receive vaccine?
|
Do you currently have any Covid-19 symptoms? Ex: cough, sore throat, body aches, fever, diarrhea, vomiting
|
If yes, explain.
|
Do you have a fever, cough, shortness of breath or difficulty breathing?
|
If yes, explain.
|
Have you had any contact with confirmed or probable case of COVID-19 or person with acute respiratory illness?
|
Have you traveled outside of the U.S. in the past 14 days?
|
In the past two weeks, have you tested positive for COVID-19?
|
If yes, explain.
|
Have you had any of the following symptoms in last 10 days?
• • •
|
If yes, explain.
|
Have you received passive antibody therapy as treatment for COVID-19?
|
If yes, When?
|
I understand that air travel significantly increase my risk of contracting and transmitting the COVID-19 virus
|
|