Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *In the last 72 hours have you experienced any of the following symptoms? Check all that apply. *Fever or chillsSore throatShortness of breath or difficulty breathingFatigueNausea or VomitingDiarrheaCongestion or Runny NoseMuscle or body aches (not associated with a musculoskeletal injury or condition)None of the above symptomsIn the last 2 weeks have you had close contact (within 6 feet for a total of 15 minutes or more) with a person who has COVID-19? *YesNoHave you been out of CA in the last 14 days? *YesNoWhat's Next?
