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PHONE:  (540) 375-3040 or (540) 389-0978|HOURS:  M-F 8am-4:30pm |EMAIL:  sheriff@salemva.gov
JUROR LINE: (540) 224-8502|LOCATION:  2 East Calhoun Street, Salem, VA 24153

COVID-19 Screening Questionnaire

PHONE:  (540) 375-3040 or (540) 389-0978|HOURS:  M-F 8am-4:30pm |EMAIL:  sheriff@salemva.gov
JUROR LINE: (540) 224-8502|LOCATION:  2 East Calhoun Street, Salem, VA 24153

COVID-19 Screening Questionnaire

Your health and well-being are of the utmost importance and we are committed to providing you with a safe environment in the courthouse. Anyone coming into the courthouse will be screened and part of our screening process includes this questionnaire. Please select either "yes" or "no". If you answer "yes" to any of these questions, you must immediately contact the Clerk of Court (540-375-3067) or Sheriff's Office (540-375-3040) to report all affirmative answers.

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  • 1.  Within the last 14 days:

  • Blank Yes No
    a. Fever?
    b. Chills?
    c. Cough?
    d. Shortness of breath?
    e. Difficulty breathing?
    f. Fatigue?
    g. Muscle or body aches?
    h. Headaches?
    i. New loss of taste or smell?
    j. Sore throat?
    k. Congestion or runny nose?
    l. Nausea or vomiting?