Start Screening Your
Organization for COVID-19 Today

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

1
Diagnose
2
Close Contact
3
Symptoms

Close Contact

Do you live in the same household with, or have you had close contact with someone who in the past 14 days was diagnosed with COVID-19 or had a test confirming they have the virus?

You are a close contact of a COVID-19 positive person if, from 48 hours before their symptoms began, the person with COVID-19:

  • Lived or stayed overnight with you
  • Was your intimate sex partner
  • Took care of you or you took care of them
  • Stayed within 6 feet of you for more than 10 minutes while they were not wearing a face mask
  • Exposed you to direct contact with their body fluids or secretions (e.g., coughed or sneezed on you) while you were not wearing a face mask, gown, and gloves