checkin | Urological Assoc

1. Have you experienced any of the following symptoms of COVID-19 within the last 48 hours?

Fever greater than or equal to 100.4 degrees

New, unexplained cough associated with shortness of breath

Fatigue

Muscle or body aches

Headache

New loss of taste or smell without any other explanation

Sore Throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

I have had NONE OF THESE SYMPTOMS

2. Have you tested positive for COVID-19 in the past 10 days?

Yes

No

3. Have you been diagnosed with COVID-19 by a licensed healthcare provider in the past 10 days?

Yes

No

4. Are you currently awaiting results from a COVID-19 test?

Yes

No

5. Have you been told you are suspected to have COVID-19 by a licensed healthcare provider in the last 10 days?

Yes

No

6. Have you been exposed to anyone that CURRENTLY has ACTIVE COVID-19?

Yes

No

Due to the predicted ice/snow for our area, our office will close at 2:00 pm on Tuesday, January 21st and remain closed until Friday, January 24th. If necessary, updates will be posted as they become available.