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PATIENT - COVID-19 SCREENING FORM
Please fill out and submit this form to complete prescreening.
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    Pick a Date
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  • 4
    Select NONE OF THE ABOVE if you DO NOT have a fever AND symptoms have been improving for 24 hours.
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  • 5
    By a doctor or government authority.
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  • 6
    On a PCR test or rapid test.
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