QuForm Test

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I am fully vaccinated against COVID-19 (it has been 14 days or more since your final dose of either a two-dose or a one-dose vaccine series) I have tested positive for COVID-19 in the last 90 days (and since been cleared) The reason we ask this question is to give you a result with accurate isolation instructions. We do not collect personal health information in this tool.

Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.

Do Not Enter

Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.

Do Not Enter

Is anyone you live with currently experiencing any new COVID-19 symptoms (listed below) and/or waiting for test results after experiencing symptoms?

Children (17 years old or younger): fever and/or chills, cough or barking cough, shortness of breath, decrease or loss of taste or smell, nausea, vomiting and/or diarrhea Adults (18 years old or older): fever and/or chills, cough or barking cough, shortness of breath, decrease or loss of taste or smell, tiredness, muscle aches If the person got a COVID-19 vaccine in the last 48 hours and is experiencing mild fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”
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