Covid19 Covid-19 Self Assessment Name: First & Last In the last 24 hours, have you had any of the following symptoms:- Shortness of breath- Fever- Cough- Sore throat- Body aches No Yes In the last 14 days, have you or anyone you are close with traveled to a known Covid-19 hot spot? No Yes In the last 14 days, have you had any contact with anyone who is exhibiting the symptoms listed above or is suspected of having Covid-19? No Yes Time's up