South Florida Neurology Associates


First Point of Contact Screening

 
We are committed to providing a safe environment for our patients and staff. If you answer “YES” to any of the questions, please help us prevent the spread of germs by putting on a mask and performing hand hygiene.
1. Do you have any of the following symptoms?
    Fever
    
    
    Cough
    
    
    Difficulty breathing/shortness of breath
    
    
    Sneezing or runny nose
    
    
    Body Aches (other than from injury
    
    
    Night sweats
    
    
    Severe Headaches
    
    
    Stiff Neck
    
    
    New rashes or open sores with fever
    
    
    Eye redness, swelling or discharge
    
    
    Unexplained bleeding
    
    
    Vomiting or diarrhea
    
    
2. In the past 3 weeks have you traveled either within the US or internationally?
    
    
3. In the past 3 weeks have you had close contact with someone who has traveled either within the US or internationally?
    
    
4. Have you been in close contact with a person confirmed to have COVID-19?
    
    
    Have you been tested for COVID-19?
    
    
    Have you been vaccinated?
    
    
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