Laura Dark | Covid-19 Survey

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Have you been diagnosed with a case of Covid 19 in the past 14 days?*

Have you been asked or required to quarantine by any medical doctor or health department in the past 14 days?*

Have you traveled internationally or to any known Covid-19 hotspots in the past 14 days?*

Have you or anyone you live with had a fever, cough, or unexplained illness within the past 14 days?*

In the past 14 days have you been in contact with or cared for anyone with suspected Covid 19?*

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Covid-19 Survey