Patients & Visitors

Progressive Care with Compassion.

Coronavirus Questionnaire

Are You at Risk for COVID-19

Please complete all questions below.

1. Have you come into close contact (within 6 feet) with someone who has a laboratory confirmed COVID – 19 diagnosis in the past 14 days?
2. Do you have a fever (greater than 100.4 F or 38.0 C) OR symptoms of lower respiratory illness such as cough, shortness of breath, difficulty breathing or sore throat?

Based on the answers you provided, current recommendations are to practice social distancing and watch for symptoms. Help is available. Get the latest information at the CDC website, Loup Basin Public Health Department or Nebraska Department of Health and Human Services website.