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01/12
How are you feeling?
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We are sorry you are not feeling well!
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02/12
Please tell us about your current symptoms?
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03/12
Have you notified a sanitary-epidemiological
unit of your symptoms?
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04/12
Have you been examined by a doctor, e.g. through telemedicine?
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05/12
How many days have you been feeling unwell?
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06/12
Did you travel abroad 14 days before the symptoms appeared?
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07/12
Have you been in contact with
someone who could be infected with #COVID-19?
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08/12
Have you self isolated?
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09/12
Have you been quarantined?
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10/12
To the best of your knowledge do you suffer from any of the following diseases?
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11/12
Do you smoke?
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12/12
Have you recently received a flu vaccine?
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