information
COVID-19 Safety, Recovery and Resilience

Face coverings are required in indoor public spaces and many outdoor spaces. State policy
Access City programs, people and projects helping Portland recover. Portland United

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Health Assessment Survey

Service
Please complete this daily self-assessment survey before arriving at a City of Portland facility.

1 minute

Should I come to a City facility?

Thank you for completing this self-assessment before arriving at a City of Portland facility, to protect yourself and your community.

If you answer “yes” to any of these questions, please DO NOT come to a City of Portland facility. If you are a visitor or volunteer, call your City point of contact and let them know you will be staying home. If you are an employee, call your manager or supervisor to let them know the result of your survey and be prepared to telework if the work is able to be performed remotely. Contact should not be via email, and specific symptoms are not required to be reported.

The City is not collecting or storing personal information as a result of this survey. This tool is based on information from Multnomah County and the U.S. Centers for Disease Control and Prevention about symptoms and risks for COVID-19. It is not intended to provide medical advice, diagnose or treat a health condition. If you have specific medical concerns, please contact your healthcare provider.


Symptom Assessment

Have you had any of the following symptoms in the last 24 hours? (Only if it is new or unusual for you and not from a chronic or pre-existing condition.)

  • Shortness of breath or difficulty breathing
  • Body or muscle aches (not from exercise)
  • Cough (not from allergies)
  • Chills
  • Headache
  • Sore throat
  • New loss of taste or smell
  • Diarrhea
  • Nausea/vomiting
  • Fever >100 (please measure) or feeling feverish (if unable to measure)
  • Congestion or runny nose (not from allergies)

Vaccination Assessment
Have you received TWO Moderna or Pfizer shots, or ONE Johnson & Johnson shot more than 14 days ago?

Family Assessment

Do you live with anyone who has symptoms of COVID-19, is awaiting test results for COVID-19, or was diagnosed with COVID-19 in the last 14 days?


Contact Assessment

In the last 14 days, have you had close contact* with anyone who has symptoms of COVID-19, was diagnosed with or is awaiting test results for COVID-19?

*Close contact is defined as being closer than 6 feet for longer than 15 minutes