Self-Screening Checklist

COVID-19 Self-Screening Questionnaire

Use this questionnaire to self-observe your daily health prior to going to class or work. It was developed with criteria from the Centers for Disease Control and Prevention (CDC).

Take your temperature every day before going to class or work. If your temperature is greater than 100 degrees Fahrenheit, or if you answer YES to any of the following questions, please DO NOT GO TO CLASS OR WORK.

Questions:

  1. Have you been tested for COVID-19 (awaiting results)? If yes, quarantine until your results are received. Students who were tested off-campus should notify the Wellness Center that they are awaiting results.
  2. Have you tested POSITIVE for COVID-19? If yes, quarantine for 10 days from symptom onset or from the date you were tested (if you don't have any symptoms), 24 hours beyond resolution of fever, and improvement of symptoms.
  3. Have you been in close contact with someone who tested positive for COVID-19? If yes, quarantine and call your healthcare provider (employees) or the Wellness Center (students) for further instructions.
  4. Has a roommate been asked by a healthcare provider to isolate for COVID-19? If yes, quarantine for 14 days from the time you were last in close contact with them and return to classes or work only if you don't have any symptoms.
  5. Are you experiencing any of the following symptoms? If yes to at least one of these symptoms, please quarantine and call your healthcare provider (employees) or the Wellness Center (students).
    • 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

What to do next

Answered NO to all

Report to class or work.

Answered YES to anything

Contact your healthcare provider. Winona students can also contact the Wellness Center by first calling 507-457-1492. A nurse practitioner and registered nurse are on campus Monday through Friday. The door to the Wellness Center has moved to the north end of Vlazny Hall (closest to the athletic fields). Testing for COVID-19 is being done in collaboration with Mayo Clinic. Results are usually available within 24-36 hours. Students will be asked to quarantine in their room until their results are available. Arrangements will be made for notification of faculty through the Student Success Center and provision of food to students while in quarantine. Employees should contact Human Resources at 507-457-1508 and their supervisors.

Additionally, you may use either of these online self-screening tools: