Do you currently have ANY of these symptoms:
- temperature 100.0 degrees or higher,
- sore throat or nose congestion,
- body aches, chills, or fatigue,
- cough or shortness of breath,
- headache,
- new loss of taste or smell,
- nausea, vomiting or diarrhea?
YES NO
- Have you had any of these symptoms in the last 10 days?
YES NO
- Have you been diagnosed with COVID-19 in the past 6 weeks?
YES NO
- Have you been tested for COVID-19 recently, but have not received the results yet?
YES NO
- Have you had contact with someone with known or suspected COVID-19 in the last 14 days?
YES NO
- Have you traveled outside of Kansas or Missouri in the past 2 weeks?
YES NO
- Have you traveled on a cruise ship or river cruise within the last 2 weeks?
YES NO
- Have you attended a gathering 500 or more people (inside or outside), where individuals were not social distanced (6ft or more) AND wear a mask, in the last 2 weeks?
YES NO