Global Ventures at FAU Covid-19 QuestionnaireDate (required)Name (required)Company/Organization (required)Have you travelled to India, Brazil, Russia, France, United Kingdom or Turkey or the greater Los Angeles area, Miami Dade County, greater Chicago area, the greater Houston or the greater Phoenix area in the last fourteen (14) days? (required)NOYESHave you had close contact with anyone who has travelled to any of the countries or cities listed above in the last fourteen (14) days? (required)NOYESHave you had close contact with or cared for someone diagnosed with COVID-19 within the last fourteen (14) days? (required)NOYESHave you experienced any cold or flu-like symptoms in the last fourteen (14) days (including fever, cough, sore throat, respiratory illness, difficulty breathing)? (required)NOYESThere was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.