Have you had a fever of 100.0 F or greater in the last 72 hours?

Have you had any of the following conditions in the last 24 hours? 

• Flu-like or cold-like symptoms

• Cough / sore throat 

• Sneezing / runny nose 

• Aches and pains 

• Diarrhea 

Have you recently been in close contact with anyone exhibiting these symptoms in the last 10 days?