COVID-19 Self Assessment This tool will help you determine if you should be tested for COVID-19. It is not a substitute for a medical professional, and your results should not be considered to be a diagnosis. Do you/they have any of the following life-threatening symptoms:*- Extremely difficult breathing or severe shortness of breath (gasping for air, cannot talk) - Blue-colored lips or face - Constant pain or pressure in the chest - Severe constant dizziness or lightheadedness - Acting confused - Difficult to wake up - Slurred speech (new or worsening) - New seizure or seizures that won't stop Yes No Call 911 - You may be having a medical emergency. Call 911 now. Immediate medical attention is needed. Tell the 911 operator if you have been in contact with someone with COVID-19 or if you have recently been to an area where COVID-19 is spreading.Do you /they have any of the following symptoms:- Moderate to severe difficulty breathing (unable to speak full sentences) - Coughing up blood (more than one teaspoon) - Signs of low blood pressure (feeling cold, pale, clammy skin, light-headed, too weak to stand) Yes No Urgent medical attention may be needed. Please go to the Emergency Department. Go to the nearest emergency department. Urgent medical attention may be needed. Tell the emergency staff if you have had contact with someone with COVID-19 or if you have recently been to an area where COVID-19 is spreading.Do you/they have any of the following symptoms:- Fever or feeling feverish (chills, sweating) - Shortness of breath (not severe) - Cough - Loss of sense of smell or taste Yes No Sorry you’re feeling ill. Stay at home and monitor your symptoms. Call your provider if you get worse. Continue to monitor your symptoms. If they get worse, call your healthcare provider, clinician advice line, or telemedicine provider. Here are some steps that may help you feel better: - Stay at home and rest. - Drink plenty of water and other clear liquids to prevent fluid loss (dehydration). - Cover your coughs and sneezes. - Clean your hands often. Contact an urgent care or emergency department if your symptoms get worse.Do you/they live in a long-term care facility or nursing home? Yes No Contact a healthcare provider in the long-term care facility where you live. Living in a long-term care facility or nursing home may put you at a higher risk for severe illness. Tell a caregiver at the facility that you are sick and need to see a medical provider as soon as possible. Help protect others from getting sick: - Stay in your room except to get medical care - Cover your coughs and sneezes - Clean your hands often Read 10 ways to manage your health and take care of yourself at home.In the last two weeks before you were sick, did you/they:- Have contact with someone diagnosed with COVID-19 - Live in or visit a place where COVID-19 is spreading Yes No In the last two weeks have you/they worked or volunteered in a hospital, emergency room, clinic, medical office, long-term care facility or nursing home, ambulance service, first responder services, or any health care setting or taken care of patients as a student or part of their work? Yes No Sorry you’re feeling ill. Stay at home and monitor your symptoms. Call your provider if you get worse. Continue to monitor your symptoms. If they get worse, call your healthcare provider, clinician advice line, or telemedicine provider. Here are some steps that may help you feel better: - Stay at home and rest. - Drink plenty of water and other clear liquids to prevent fluid loss (dehydration). - Cover your coughs and sneezes. - Clean your hands often. Read 10 ways to manage your health and take care of yourself at home.Contact the occupational health provider at your workplace immediately. Please contact the occupational health provider in your healthcare facility as soon as possible. Tell the occupational health provider that you have some symptoms that may be related to COVID-19. You have one or more symptom(s) that may be related to COVID-19. Stay home and take care of yourself. Call your healthcare provider, clinician advice line, or telemedicine provider within 24 hours, and start home isolation immediately. This means stay home except to get medical care, and do not go to work, school, or public areas or use public transportation. Read 10 ways to manage your health and take care of yourself at home.Stay home and take care of yourself in home isolation. Call a medical provider within 24 hours. Sorry you’re feeling ill. You have one or more symptom(s) that may be related to COVID-19. Stay home and take care of yourself. Call your healthcare provider, clinician advice line, or telemedicine provider within 24 hours, and start home isolation immediately. This means stay home except to get medical care, and do not go to work, school, or public areas or use public transportation. Read 10 ways to manage your health and take care of yourself at home.Stay home and take care of yourself. Call your provider if you get worse. Sorry you’re feeling ill. You have one or more symptom(s) that may be related to COVID-19. Stay home and take care of yourself. Read 10 ways to manage your health and take care of yourself at home. Follow these steps now to help protect others from getting sick. Contact an urgent care or emergency department if your symptoms get worse.
