CDEs
Forms
Believe that I was exposed to someone who has COVID-19.
To know if I am safe not to give COVID-19 to friends and family.
To know if I am safe not to give COVID-19 to anyone I am around.
To let my employer know that I am safe to work.
To get treated early (if I am positive).
May experience discomfort from being tested.
Even if I don't have it when tested, I can still get COVID-19 later.
I don't have COVID-19 symptoms so I don't need to be tested.
If I'm positive, officials will need to contact the people I've been in contact with.
I don't want to know if I have it.
Not much they can do for me if I have it.
Difficult to get needed healthcare if I have it.
I plan to get tested as often as needed.
If I get a negative test result, it means [check all that apply]:
If I get a positive result, it means: [check all that apply]
Date of Medication Collection
Do you currently take prescription medications?
Prescription Medication 1
Prescription Medication 2
Prescription Medication 3
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