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The COVID-19 Basic Needs Intake Form


As a reminder, wash your hands often using proper handwashing techniques, wear a mask that covers your nose and mouth, maintain 6 feet between yourself and people who do not live in your household, cover coughs and sneezes, clean and disinfect frequently touched surfaces, and monitor your health daily.

If you or someone you are caring for experience symptoms, call your physician and use the COVID-19 Screening Tool to help you understand what to do next. You can also download the COVID-19 Screening Tool via Apple Store or Google Play