Coronovirus/COVID-19 Screener

IF YOU SUSPECT YOU MAY HAVE CORONAVIRUS (COVID-19), PLEASE COMPLETE AND SUBMIT THIS QUESTIONNAIRE. A REPRESENTATIVE FROM MARKET STREET MEDICAL WILL CONTACT YOU WITHIN 2-3 HOURS IF COMPLETED BETWEEN  8AM & 3PM, OTHERWISE IT WILL BE THE NEXT BUSINESS DAY. 

*This is just a screening tool and IS NOT a substitute for medical care. If you have further concerns please call 618-392-1301

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DO YOU HAVE ANY OF THE FOLLOWING:
IN THE PAST 14 DAYS HAVE YOU:
DO ANY OF THESE SITUATIONS APPLY TO YOU:

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