Do you have symptoms of cough?

Rate the cough severity on a scale of 1‐10

Do you have symptoms of shortness of breath?

Rate the severity of shortness of breath on a scale of 1‐10

Do you have any of the following risk factors:

• Fever > 100.0° F
• Age ≥ 60 years
• Diabetes
• Chronic heart disease
• Chronic lung disease
• Chronic kidney disease
• Receiving immunosuppressive medication