Please attest that you have not experienced one or more of the following symptoms in the last 24 hours (not related to chronic, known conditions or seasonal allergies):
  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea
I attest that I have not experienced one or more of the listed symptoms in the last 24 hours.
  • MM slash DD slash YYYY