With coronavirus now detected in our region, we want to do our part to minimize the spread of cold/flu or coronavirus. Please provide us with the following information for your upcoming appointment.
Interviewer:
Individual Served:
Location:
Date:
Time:
Does the patient/client or individual accompanying present with any of the following symptoms?
- Yes, is this the patient/client or individual accompanying Specify __________________
- Fever Duration of Symptoms
- Cough Duration of Symptoms
- Shortness of breath Duration of Symptoms
Does the patient or individual accompanying have any of the following exposures?
- Travel outside of the United States? Specify
- Traveled to any affected area within the United States? Specify
- Community contact with a lab confirmed or suspected COVID-19 case patient?
- If yes, where was the contact made? Specify________________________________
- Household contact with a lab confirmed or suspected COVID-19 case patient?
- If yes, who in the household? Specify______________________________________
If you experiencing these symptoms, please go to your local hospital or emergency room immediately and test for the virus. MHHC & your local health department are unable to provide testing for COVID-19. The Missouri Department of Health and Senior Services (DHSS) activated a statewide public hotline for citizens needing guidance regarding the novel coronavirus. The hotline can be reached at 877-435-8411. The hotline is being operated by medical professionals and is available 24 hours a day, 7 days a week.
Thanks for your patience and understanding as we continue to make decisions and develop plans to protect the well-being of all staff, individuals served and community members.
Please call your local clinic or the 877-435-8411 hotline number before entering into a clinic or ER. Thank you.