STAGE 2 HEALTH QUESTIONNAIRE
Are you experiencing any of the following?
· Severe difficulty breathing (e.g. struggling to breathe or speaking in single words) · Severe chest pain
· Having a very hard time waking up
· Feeling confused
· Losing consciousness
Are you experiencing any of the following?
· Mild to moderate shortness of breath
· Inability to lie down because of difficulty breathing
· Chronic health conditions that you are having difficulty managing because of difficulty breathing
Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones?
· Fever
· Chills
· Cough or worsening of chronic cough
· Shortness of breath
· Sore throat · Runny nose
· Loss of sense of smell or taste
· Headache
· Fatigue
· Diarrhea
· Loss of appetite
· Nausea and vomiting
· Muscle aches
Less common Symptoms can include:
· Stuffy nose
· Conjunctivitis (pink eye)
· Dizziness
· Confusion
· Abdominal pain
· Skin rashes
· Discoloration of fingers or toes
If you answer yes to any of these questions, please do not come to school or work and call 8-1-1. Please let your Principal or Supervisor know.