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Covid-19 Questionnaire

Please list all the countries and cities, whether abroad or in the UK that you have visited in the 14 day period immediately prior to your planned appointment at FMU.
Have you visited countries, regions, cities (both home and abroad) with active community transmission?
Have you been in close contact with anyone from countries, regions, or cities ( home and abroad)?
Have you been suspected or confirmed of having Covid-19?
Have you had or do you have now any signs or symptoms of seasonal flu or Covid-19 including but not limited to: fever or higher than normal temperature, persistent cough, respiratory illness, unusual chills or sweating, shortness of breath, loss of taste and smell, other flu-like symptoms?
Have you been in contact with anyone suspected or confirmed of having being infected with Covid-19?
Are you currently ill? Please explain your symptoms.
Do you or your partner have any objections to sanitising your hands and wearing a face mask during the scan?