Self-Assessment Health Checklist for Visiting Social Security Offices (En espaƱol)

All visitors, employees, and guards must review the self-assessment below before allowed to enter. You may not enter the office if your answer to any of these questions is YES, regardless of your vaccination status. Masks are required for all visitors, employees, and guards.

  1. Do you have any new or worsening symptoms of COVID-19 including:
    • Fever (100.4 degrees or higher);
    • Cough or sore throat;
    • Shortness of breath or difficulty breathing;
    • Fatigue;
    • Muscle pain or body aches;
    • Headache;
    • New loss of taste or smell;
    • Congestion or runny nose; or
    • Nausea, vomiting, or diarrhea?
  2. Within the last 10 days, have you:
    • Been diagnosed with COVID-19;
    • Received instructions from a public health authority (local health authority, medical professional, etc.) to self-monitor for symptoms of COVID-19 or self-quarantine due to COVID-19;
    • Been tested for COVID-19 and are awaiting the results (other than for travel purposes); or
    • Been in close physical contact with anyone who was diagnosed with COVID-19 or developed symptoms consistent with COVID-19?
  3. Within the last 5 days, have you:
    • Traveled outside the country by means other than land travel, such as car, bus, ferry, or train?
    • Close physical contact is defined as being within 6 feet of an infected/symptomatic person for a cumulative total of 15 minutes or more over a 24-hour period starting from 48 hours before illness onset (or, for asymptomatic individuals, 48 hours prior to test specimen collection).

If you answered YES to any of these questions or if you feel ill, please do not enter the facility until you are symptom free. If you need immediate assistance, please call 1-800-772-1213 or visit

If you answered NO, you must wear a face covering over your mouth and nose to enter this facility. If you do not have one, we will provide you with one.