
COVID-19 Daily Self- Monitoring Checklist
☐Do you have a Fever (temperature of 100.4 F or higher) without having taken any fever reducing medications?
☐Do you have Chills?
☐Do you have a Cough?
☐Do you have Shortness of Breath or Difficulty Breathing?
☐Do you have Congestion or a Runny Nose?
☐Do you feel Fatigued?
☐Do you have Muscle Aches?
☐Do you have a Sore Throat?
☐Do you have a Headache?
☐Do you have a New Loss of Smell or Taste?
☐Have you experienced any gastrointestinal symptoms such as nausea/vomiting, diarrhea, loss of appetite?
☐Have you, or anyone you have been in close contact with been diagnosed with COVID-19, or been placed on quarantine for possible contact with COVID-19?
☐Have you been asked to self-isolate or quarantine by a medical professional or a local public health official?
If you reply YES to any of the questions in the checklist, STAY HOME and call your healthcare provider for guidance on testing/medical care.