• COVID-19 SCREENING QUESTIONNAIRE
    (AS OF 3/31/2020)

    An outbreak of 2019 Coronavirus (COVID-19) requires early and effective detection of suspected cases to limit the risk of exposure to others. We are kindly requesting you to complete the following questions.
  • Date Format: MM slash DD slash YYYY
  • If you have any of the symptoms listed above, you are required to contact your medical provider and NOT enter the STI Group Facility.