• Pittsburgh Theological Seminary

    Daily Health Questionnaire
  • Device Time
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  • According to the U.S. Centers for Disease Control and Prevention & the World Health Organization, COVID-19 Symptoms include:

    • Fever or chills
    • Cough
    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea
  • Are you experiencing any of the COVID19 related symptoms noted above OR have tested positive in the past 5 days?*
  • Have you been fully vaccinated against COVID19?*
  • Have you been in close contact with someone who has tested positive for COVID-19 in the last 5 days?*
  • Have you been tested for COVID-19 in the last seven days
  • What were the results of the test?
  • Are you living with or caring for an individual who is a suspected or confirmed case of COVID - 19?
  • Have you been in contact with anyone known or suspected to have COVID - 19 in the last 14 days?
  • Have you tested positive for COVID-19 in the last 14 days?

  • I certify all the information provided is shared to the best of my ability.

  • Should be Empty: