Check the box in Column A or Column B that most closely fits your symptoms.
(If you do not have a thermometer, you may purchase one at the Student Health Service Cashier’s window or at any drug store. Temperatures below are in degrees Fahrenheit.)
Symptom Column A Column B
1. Fever No fever or fever less than 100.5 which has lasted 7 days or less Fever more than 102 today or fever of 100.5 or more for 3 days or longer
2. Severe sore throat with significant difficulty swallowing saliva No Yes
3. Sore throat for more than 7 days No Yes
4. Sore throat with white patches in the back of the throat No Yes
5. Painful swelling of the lymph nodes or glands of the neck No Yes
6. Facial tenderness No or Mild Moderate or Severe
7. Colored nasal mucus None or less than 7-10 days More than 7-10 days
8. Cough None or less than 5 days with clear to yellow mucus Yellow or green mucus for 5 days or more or bloody mucus
9. Cough with no other symptoms for more than 2 weeks No Yes
10. Shortness of breath or labored breathing No Yes
11. Wheezing No Yes
12. Headaches Moderate or Mild Severe
13. Ear pain No or Mild Moderate or Moderate or severe
14. Red rash over body No Yes
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