QuForm TestPage 1 of 9How old are you?*17 years old or younger18 years old or olderNextDo any of the following apply to you?*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.YesNoBackNext(Under 17) Are you currently experiencing any of these symptoms?*Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.Fever and/or chills:Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higherCough or barking cough (croup):Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have)Shortness of breath:Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have)Decrease or loss of taste or smell:Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already haveNausea, vomiting, and/or diarrhea:Not related to irritable bowel syndrome, anxiety, menstrual cramps, or other known causes or conditions you already haveNone of the aboveBackNextDo Not Enter(Over 18) Are you currently experiencing any of these symptoms?*Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.Fever and/or chills:Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higherCough or barking cough (croup):Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have)Shortness of breath:Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have)Decrease or loss of taste or smell:Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already haveMuscle aches/joint pain: Unusual, long-lasting (not related to getting a COVID-19 vaccine in the last 48 hours, a sudden injury, fibromyalgia, or other known causes or conditions you already have)Extreme tiredness: Unusual, fatigue, lack of energy (not related to getting a COVID-19 vaccine in the last 48 hours, depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have)None of the aboveBackNextDo Not EnterIs 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.”Living with Symptoms*YesNoBackNextDo Not EnterEnterThis field should be left blank
