HAVE YOU HAD ANY OF THE FOLLOWING IN THE PAST 3 DAYS: Cough, Shortness of Breath, Difficulty Breathing, Fever, Chills, Muscle Pain, Sore Throat, Headache, Nausea or Vomiting, Diarrhea, Runny or Stuffy Nose, Fatigue, Recent Loss of Taste or Smell, Poor Feeding or Appetite (Infants & Children) *

RISK FACTORS Have you been in close contact (less than six feet) with anyone with Covid-19 or symptoms of Covid-19 in the past 14 days? NOTE: Public health, public safety, and healthcare workers are exempt. *

Have you traveled anywhere outside the 50 United States in the past 14 days? *

Have you traveled to Connecticut from another state for a non-work-related purpose in the past 14 days? *

Have you been directed to quarantine or isolate by the CT Department of Health or a healthcare provider in the past 14 days? *