Start Screening Your
Organization for COVID-19 Today

REGISTER

Welcome to the SAMPLE Coronavirus Screening Survey. Answer the questions below to assess your risk of exposure.

1
Diagnose
2
Close Contact
3
Symptoms

Symptoms

Have you had any one or more of these symptoms today or within the past 24 hours, which is new or not explained by a pre-existing condition?

  • Fever, Chills, or Repeated Shaking/Shivering
  • Cough
  • Sore Throat
  • Shortness of Breath, Difficulty Breathing
  • Feeling Unusually Weak or Fatigued
  • Loss of Taste or Smell
  • Muscle pain
  • Headache
  • Runny or congested nose
  • Diarrhea
  • Nausea or Vomiting