By checking the boxes below I certify that I DO NOT have anyone in my household that:
If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:
• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face
*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.