061 334023 | info@downsyndromelimerick.ie
061 334023 | info@downsyndromelimerick.ie

COVID-19 Questionnaire

Please fill in the questionnaire below with your details.
Please complete within 24 hours prior to arrival at Down Syndrome Limerick.

    Please do not attend the service if you answer Yes to any of the above questions. While we understand this might cause an inconvenience to you, we are acting in the best interest of all of our members.

    Common Symptoms

    Less Common Symptoms

    Severe Symptoms

    Fever (temperature > 38C)

    Change to sense of smell

    Shortness of breath


    Change to sense of taste

    Loss of appetite

    Dry cough

    Nasal congestion




    Chest pain/pressure

    Sore throat


    Muscle of joint pain

    Skin rash

    Nausea, vomiting or diarrhoea


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