You should proceed to the emergency department.

You should proceed to the emergency department.

You should proceed to the emergency department.

Is/was the patient admitted to ICU?

Is/was the patient intubated?

Is/was the patient On ECMO?

Does the patient live in a labor camp?
If (Yes) please fill the fields below.

Have history of being in a healthcare facility ( as a patient, worker, or visitor) during the last 14 days?

Detection Facility:

Type:

Educational Institute Type:

Education Type:

This field is required.
Please add the two figures together (spam protection)