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Patient and Visitor COVID-19 Screening Application

The following screening questions are meant to identify visitors and patients at risk for having COVID-19 infection before, or immediately upon arrival to a Baptist Health facility.

This screening tool should not be used by Baptist Health employees reporting to work.

No data is being stored by Baptist Health.

Have you experienced any of the following symptoms in the past 48 hours?

  • fever or chills
  • cough
  • shortness of breath or difficulty breathing
  • fatigue
  • muscle or body aches
  • headache
  • new loss of taste or smell
  • sore throat
  • congestion or runny nose
  • nausea or vomiting
  • diarrhea


Within the past 10 days, have you tested positive for COVID-19, been suspected of having COVID-19, or have a pending test for COVID-19?


Within the past 10 days, have you had close contact with someone with confirmed COVID-19?