Covid 19 Screening Are you fully vaccinated (please select appropriate answer) 1 Vaccine2 Vaccines3 Vaccines Are you, or anyone in your family feeling unwell with flu-like symptoms such as a sore throat, fever, cough, shortness of breath, or recent loss of taste or smell? YesNo Have you been to the North Island in the last 14 days? YesNo Do you, or a close contact, have a probable or confirmed COVID-19 case? YesNo Have you, or a close contact, been asked to quarantine/self isolate over the past 14 days? YesNo if yes – has the quarantine period now finished? YesNo In the past 14 days, have you worked on an aircraft or shipping vessel or worked in a facility visited by international arrivals? YesNo Have you or a close contact of yours visited a location of interest in the last 14 days? (if you are unsure please refer to the MOH website) YesNo Do you or a close contact have any underlying health concerns or reasons that you would be deemed more vulnerable if you were to become ill? YesNo When was your last vaccine/do you have any booked? (this applies to any vaccine or immunisation) some treatments require precautionary wait times between any vaccine/immunisation and treatment.