COVID-19 Self Assessment Welcome to your COVID-19 Self Assessment This resource can help you decide what kind of medical care you might need for COVID‑19 For informational purposes only Not a medical diagnosis Private and secure Your answers aren't collected or shared Are you answering for yourself or someone else?MyselfSomeone else What is your age?18-2930-3940-4950-5960-6465-6970-7980+ Do you have any of these life-threatening symptoms? Bluish lips or face Severe and constant pain or pressure in the chest Extreme difficulty breathing (such as gasping for air, being unable to talk without catching your breath, severe wheezing, nostrils flaring) New disorientation (acting confused) Unconscious or very difficult to wake up Slurred speech or difficulty speaking (new or worsening) New or worsening seizures Signs of low blood pressure (too weak to stand, dizziness, lightheaded, feeling cold, pale, clammy skin) Dehydration (dry lips and mouth, not urinating much, sunken eyes) YesNo Are you feeling sick?YesNo In the last two weeks, did you care for or have close contact (within 6 feet of an infected person for at least 15 minutes) with someone with symptoms of COVID-19, tested for COVID-19, or diagnosed with COVID-19?YesNoI don't know Do you live in a long-term care facility, nursing home, or homeless shelter?YesNo In the last two weeks, have you worked or volunteered in a healthcare facility or as a first responder?Healthcare facilities include a hospital, other medical setting (including dental care setting), or long-term care facility.YesNo Email Address Take the COVID-19 Self Assessment to find out how you or your loved one may be at risk for COVID-19.
