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Gathering Informations

COVID-19 PRE SCREENING

COVID-19 Pre Screening Questionnaire: Image

PRE-SCREENING QUESTIONNAIRE 

YES   /    NO

1. Have you be tested positive for COVID-19 in the last 10 days?

YES   /    NO

2. Are you waiting for a COVID-19 test ora test result?

YES   /    NO

3. Have you been notified by NHS Test and Trace or the NHS COVID-19 App in the last 10 days that you need to self-isolate?

YES   /    NO

4. Do you have a high temperature or a fever or have had this symptom in the last 10 days?

YES   /    NO

5. Do you have a continuous cough or have had this symptom in the last 10 days

YES   /    NO

6. Do you have any change or loss of smell or taste from normal or have had this symptom in the last 10 days?

YES   /    NO

7. Do you live with some who's either tested positive for COVID-19 or had symptoms in the last 10 days?

YES   /    NO

8. Have you returned to the UK from abroad in the past 10 days?

COVID-19 Pre Screening Questionnaire: List

OUTCOMES

If the patients answers NO to all the above questions you can confirm the.appointment 

COVID-19 Pre Screening Questionnaire: Text
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