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CRL COVID-19 Pre-Screening Tool [Mon-Sat Visit]
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3
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1
Do you, or anyone attending with you, have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.
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Fever, chills, or cough; Difficulty breathing or shortness of breath; Sore throat or trouble swallowing; Runny nose/stuffy nose or nasal congestion; Decrease loss of smell and/or taste; Nausea, vomiting, diarrhea, abdominal pain; Not feeling well, extreme tiredness, sore muscles
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2
Have you, or anyone attending with you travelled outside of the country in the past 14 days?
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3
Have you , or anyone attending with you had close contact with a confirmed or probable case of COVID-19?
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