NYC Test and Trace Program

Test and Trace Program objective is to stop COVID 19 infections in NYC. During this call I’ll be asking
you some questions about your health and about the people that you may have been in close contact with.
Also, to provide you information on how to access services that you may need.

Assure you that the information you provide will be kept confidential to the fullest extent of the law. I’m
a contact tracer, not a doctor or a nurse so I can’t provide you personalized medical advice.

COVID 19 is a virus that spreads from one person to another through breathing, coughing and sneezing. It
causes mild illness in the majority of the people but can cause severe illness to others that end up in
hospitalization or death.

Emergency warning signs associated with COVID 19:

• Change of color blue gray on the face, lips and inside of the mouth.
• Extreme difficulty waking up
• Loss of consciousness
• Lack of air
• Gasping for air
• Confusion
• Pressure or pain on the chest

If you or someone in your house is experiencing any of these síntomas, please call 911 or seek por
emergency medical care.

Now I’ll ask you some basic questions about yourself.

Best contact number
DOB
Address

Are you staying in NY for the next ___ days?

Are you staying at that address?
Are you staying over night the next ___ days at that address?

Now I’ll read you a list of síntomas, think about the past 3 weeks and a half when answering YES or NO
to these síntomas:
• Fever
• Cough
• Chills
• Difficulty breathing or shortness of breath
• Sore throat
• Muscle aches
• Diarrhea
• Headache
• Vomiting or cause
• Loss of smell or taste
• Fatigue
• Sinus congestion
• Chest pain
• Confusion
When did these síntomas begin? / First time these síntomas begin?
Recommend if you have any questions about COVIDD 19 or its síntomas we encourage you to speak
with your dr. If you don’t have one or can’t get a hold on him, you can call de Test and Trace hotline at:
212 268 4319 press option 2 to speak with a nurse, dr or a provider.
212 COVID 19 option 2/ extension 2

If síntomas get worse call 911 or go to your nearest ER.

Alguien vive en casa con usted/fam members, roomies…

Names and last names.

Mantuvo contacto cercano con alguien de (fecha) hasta (fecha)?

Recommend everyone in the household to get tested si no lo han hecho.

Ha estado en contacto cercano con alguien más que no me haya dicho ya? Contacto cercano es a distancia
de 6feet por 10min o más.

Puede tomar sick leave para cuidar de usted mismo o de un family member bajo las leyes de la ciudad, del
estado y las leyes federales. Si necesita una carta para su empleador…

If need help pay time off/sick leave, help resources with a non-profit organization, food, health insurance,
meds delivery, SNAP 212 268 4319

Payed Family Leave Program 855 491 2667

Need face masks, sanitizers, thermometer package…