If you answer yes to one or more of the questions below, please select 'Yes'. Otherwise, please select 'No'.
Have you been in a community where COVID-19 is or might be spreading?
Have you recently had close contact with a person with COVID-19?
Have you or someone you live with been diagnosed with COVID-19, or are waiting for test results?
Have you traveled from somewhere outside of the United States or on a cruise ship or river boat?