COVID -19 Screening 

Please fill out the following form before you enter the building 

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Have you had a body temperature over 100 degrees Fahrenheit or have you used a fever reducer in the previous 24 hours to treat a body temperature over 100 egrees Fahrenheit?
Do you have a new cough or worsening sore throat or shorthness of breath that you cannot attribute to another health condition?
Have you recently developed a complete loss of smell or taste?
Have you been asked to self-isolate or quarantine by anyone, including your employer, a medical professional or a local public health official, or have you returned from travel from a location currently experiencing a surge in new COVID-19 cases and requiring self-quarantine per a City of Chicago emergency travel order, in the last 14 days?
Have you recently been tested for COVID-19, and are you awaiting results?

Thanks for submitting!