1. Do you have any of the following new or worsening symptoms?

  • 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

Injured? Call Northern Light Orthopedics for a same day appointment! 207-973-9980

2. Have you been around anyone that is known to have COVID-19 in the past 14 days?

Injured? Call Northern Light Orthopedics for a same day appointment! 207-973-9980

3. Have you been advised to self-quarantine because of exposure to someone with COVID-19 infection within the last 14 days?

Injured? Call Northern Light Orthopedics for a same day appointment! 207-973-9980

Have you traveled outside of the state of Maine or one of the states exempted from being quarantined in the last 14 days?

Injured? Call Northern Light Orthopedics for a same day appointment! 207-973-9980

 

Please proceed to screening and show this green check when requested.

Based on the information you provided, please proceed to the next step of your employer’s screening process. Please do not refresh or leave this page until then and note this response will expire in four hours.

Answering "Yes" or "No" to any of these questions does not guarantee that you are or are not ill, or have been or have not been exposed to COVID-19. Please talk to your health care provider if you have any questions or concerns.

Injured? Call Northern Light Orthopedics for a same day appointment! 207-973-9980

Please proceed to screening and show this green check when requested.

Based on the information you provided, please proceed to the next step of the screening process. Please do not refresh or leave this page until then and note this response will expire in four hours.

Answering "Yes" or "No" to any of these questions does not guarantee that you are or are not ill, or have been or have not been exposed to COVID-19. Please talk to your healthcare provider if you have any questions or concerns.

This Questionnaire is provided at no cost by Northern Light Health, which has no control over its utilization by third parties. It is not intended as medical advice to any specific individual and/or group and may not be used as such for any purpose.

 

Please do not proceed to the next step of your employer’s screening process. Call your local HR business partner or the hospital operator to connect you.

Answering "Yes" or "No" to any of these questions does not guarantee that you are or are not ill, or have been or have not been exposed to COVID-19. Please talk to your health care provider if you have any questions or concerns.

If you are experiencing severe or life-threatening symptoms, please call 911.

Please do not proceed to the next step of the screening process.

Based on the information you provided, you currently have symptoms that could be consistent with COVID-19. Self-isolate at home and contact your primary care physician’s office or the COVID-19 Hotline at

1-844-489-1822

Answering "Yes" or "No" to any of these questions does not guarantee that you are or are not ill, or have been or have not been exposed to COVID-19. Please talk to your health care provider if you have any questions or concerns.

If you are experiencing severe or life-threatening symptoms, please call 911.
CDC: What to do if sick

This Questionnaire is provided at no cost by Northern Light Health, which has no control over its utilization by third parties. It is not intended as medical advice to any specific individual and/or group and may not be used as such for any purpose.

 

Please proceed to screening and show this yellow check when requested. You may need to follow additional protocols based on your answers.

Based on the information you provided, please proceed to the next step of your employer’s screening process. Please do not refresh or leave this page until then and note this response will expire in four hours.

Answering "Yes" or "No" to any of these questions does not guarantee that you are or are not ill, or have been or have not been exposed to COVID-19. Please talk to your health care provider if you have any questions or concerns.