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In the past 14 days, have you or any household member travelled to areas of known cases of COVID-19?
In the past 14 days, have you or any household member had any contact with a known COVID-19 patient?
Have you or any household member, had/have a history of exposure to COVID-19 biologic material?
Have you had any known symptoms of COVID-19 eg; Fever, Dry Cough, Shortness of Breath, in the last 14 days?
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