Self-Screening Health Questionnaire

1. Have you tested positive for COVID-19 the past 10 days?
2. Are you currently awaiting results from a COVID-19 test?
3. Have you experienced any of the following symptoms of COVID-19 in the last 48 hours?
   • Fever or chills
   • Cough
   • Shortness of breath or difficulty breathing
   • Fatigue
   • Muscle or body aches
   • Headache
   • New loss of taste or smell
   • Sore throat
   • Congestion or runny nose (not due to allergies)
   • Nausea or vomiting
   • Diarrhea
4. Have you had close contact in the last 14 days with someone who recently tested positive for COVID-19? ***

If you answered YES to any of these questions, please do not enter the UUAA building at this time.

*** NOTE: You may answer “NO” to question 4 if you had a negative COVID test at least 3 to 5 days after your last contact with this person.