COVID-19 Case Collection Form
Complete this form if you test positive, suspect you are in close contact to someone with coronavirus (COVID-19), or are experiencing the following 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, or diarrhea.
This does not include all possible symptoms. If you feel sick, get tested. Review the information at the New York City Department of Health and the CDC. The CDC has updated isolation and quarantine recommendations for the public and is revising its website to reflect these changes.
This information will be kept confidential to the best of our ability.
