Have you been travelling in the past 4 weeks



Were you in contact with someone who has been tested positive for COVID-19



Were you in contact with a person suspected to have the disease



Have you had a fever (more than 37.8) in the past 48 hours



Do you have a cough or has it increased recently


Are you out of breath faster than usual


Do you have sore throat


Have you had muscle pain in the past days


Have you had diarrhea


Have you had a headache


Do you feel tired or weak


Have you been suffering from these symptoms for less than 2 weeks


Are you more than 50 years old



Do you have hypertension


Do you have diabetes


Do you have heart disease


Do you have kidney disease


Do you have cancer


Do you have chronic lung disease


Do you have a disease resulting in immunodeficiency (Rheumatoid Arthritis, Systemic Lupus Erythematosus, Psoriasis, Multiple Sclerosis, Sarcoidosis...)


Are you currently on steroids


Are you currently on immunosuppressive treatment


Are you obese


Are you pregnant


Do you smoke


Do you work in healthcare industry


As a health care worker, were you adhering to the protective precautions when you are in contact with patients