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STDs & Women’s Health
NEWS & UPDATES
Pre Question Form
All fields are required.
In the past 14 days, have you tested positive for COVID-19?
In the past 14 days, have you been in close contact with anyone who tested positive for COVID-19?
Are you currently experiencing fever, coughing, shortness of breath, the new loss of taste or smell, or any other COVID-19 symptoms?
In the past 14 days, have you had a non-COVID-19 vaccination?
In the past 90 days, have you received monoclonal antibodies or convalescent plasma for COVID-19 treatment?
Did you have a severe allergic reaction (e.g., anaphylaxis) to component of the COVID-19 vaccine or after a previous dose?
Did you have a known (diagnosed) allergy to a component of the vaccine or an immediate allergic reaction of any severity to a previous dose?
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