COVID-19 At-Home Test Kit Survey
Please describe the option that best describes your symptoms:
If you have both severe and mild symptoms, select severe.
Severe
- I have a fever of 102° F or higher, OR I have a fever that has lasted longer than 48 hours.
- I can’t speak in full sentences or do simple activities without feeling short of breath.
- I am having severe coughing spells, or I am coughing up blood.
- My lips or face are blue.
- I have severe and constant pain or pressure in my chest.
- I feel very tired or lethargic.
- I feel dizzy, lightheaded, or too weak to stand.
- I am having slurred speech or seizures.
- I do not feel like I can stay at home because I feel seriously ill.
Mild
- I have a fever between 100.4° F and 102° F, am feeling feverish, or feel warm to the touch.
- I have a new or worsening cough.
- I have a new or worsening sore throat.
- I am having flu-like symptoms (chills, runny or stuffy nose, headache, body aches, and/or feeling tired).
- I am having shortness of breath that is not limiting my ability to speak.
- I have new loss of taste or smell.
- I have new nausea or vomiting.
- I have new diarrhea.
At Risk
- I am having symptoms not listed in the other two choices.
- Close contact with an infected person
- Attending Colleges, Universities, or Workplace
- Travel
- Events
- Being in crowded indoor setting
- Have been asked or referred to get testing by healthcare provider, state, tribal, local, or territorial health department