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* 1. Have you traveled internationally within the last 14 days to a country with sustained community transmission?

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* 2. Do you have signs or symptoms of COVID-19, such as fever, chills, cough, shortness of breath, difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion, runny nose, nausea, vomiting or diarrhea?

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* 3. In the last 14 days, have you had contact with someone diagnosed with COVID-19, under investigation for COVID-19, or with a respiratory illness?

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* 4. Do you live in an area where community-based spread of COVID-19 is occurring?

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