Name* First Last Email* Have you experiences a fever of 38°C or greater in the past 14 days?* YES NO Have you received a positive result from a COVID-19 test within the past 14 days?* YES NO In the past 14 days, have you been in close contact with anyone that has or had symptoms of COVID-19 that required you to quarantine?* YES NO In the past 14 days, have you or someone you have been in close contact with traveled to an area that required quarantine upon return?* YES NO In the past 14 days, have you been in close contact with anyone that has or had symptoms of COVID-19 that required you to quarantine?* YES NO In the past 14 days, have you been in close contact with anyone that has or had symptoms of COVID-19 that required you to quarantine?* YES NO
