COVID-19 SELF ASSESSMENT Have you tested positive with a PCR or rapid COVID- 19 test within the past 10 days? Yes No Were you exposed to someone who tested positive for COVID-19? True exposure is defined as: – Being with the positive individual within 6 feet for more than 15 minutes cumulatively within a 24-hour period AND – The above exposure occurring during their illness OR within the 48 hours prior to their symptoms presenting OR within the 48 hours prior to their positive COVID-19 test (if they were asymptomatic to testing). Yes No Do you have 2 or more low-risk symptoms OR 1 or more high-risk symptoms? Low-Risk: General Symptoms (2 or more) – Fever (≥100.4°F)– Congestion/Runny Nose– Nausea/Vomiting/Diarrhea– Sore Throat– Headache– Fatigue/Muscle or Body Aches High-Risk: Red Flag Symptoms (1 or more) – Cough (new onset affecting quality of life)– Difficulty Breathing– Loss of Taste/Smell Yes No Submit your assessment now. Do you have 2 or more low-risk symptoms OR 1 or more high-risk symptoms?* Low-Risk: General Symptoms (2 or more) – Fever (≥100.4°F)– Congestion/Runny Nose– Nausea/Vomiting/Diarrhea– Sore Throat– Headache– Fatigue/Muscle or Body Aches High-Risk: Red Flag Symptoms (1 or more) – Cough (new onset affecting quality of life)– Difficulty Breathing– Loss of Taste/Smell Yes No Are you fully vaccinated? You are considered fully vaccinated if you have been boosted or completed a primary series of Pfizer or Moderna vaccines within the last 6 months. You are also considered fully vaccinated if you been boosted or have received the primary vaccine of Johnson & Johnson within the last 2 months. Yes No Time is Up! Time's up