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COVID-19 Screening Form

Pre-visit COVID screening. Professional covid-19 screening form template.

Questions 7
Est. Time 2 minutes
Category Healthcare
Type Intake, Contact
Healthcare
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Questions in this template
1
short text
Patient name
2
date
Date of birth
3
multiple choice
Fever in last 14 days?
4
multiple choice
COVID symptoms?
5
multiple choice
COVID exposure?
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