Sign up here

1. Are you feeling sick today?

2. In the past 14 days have you had contact with a confirmed COVID-19 patient?

3. Have you ever had a positive test for COVID-19 or has a doctor told you that you have COVID-19?

4. Have you received passive antibody therapy or convalescent plasma as a treatment for COVID-19 in the last 90 days?

5. Are you immunocompromised? (taking medication or being treated for cancer, leukemia, HIV/AIDS or other immune system problems or taking medication that affects your immune system)

5a. Do you have a heart disease?

5b. Do you have diabetes? (Type I or Type II)

5c. Do you have a chronic kidney disease?

5d. Do you have a chronic lung disease? (Asthma, COPD, Emphysema)

5e. Do you have a neurologic disease? (Alzheimer's, Amyotrophic Lateral Sclerosis, Bell's Palsy, Epilepsy/Seizures, etc.)

6. Do you have High Blood Pressure

7. Have you ever received a dose of COVID-19 vaccine?

8. Do you have any current issues with your weight?