1: Never	2: Sometimes	3: About half the time	4: Most of the time	5: Always
1.Use a hand sanitizer that contains at least 60% alcohol, if soap and water are not readily available. (Hand sanitizer)	□	□	□	□	□
2.Avoid touching your eyes, nose, and mouth with unwashed hands. (Don’t touch face)	□	□	□	□	□
3.Avoid close contact with people who are sick. (Avoid close contact)	□	□	□	□	□
4.Put distance between yourself and other people if COVID-19 is spreading in your community. (Distance from others)	□	□	□	□	□
5.Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. (Cover cough/sneeze)	□	□	□	□	□
6.Throw used tissues in the trash. (Throw tissues)	□	□	□	□	□
7.After coughing or sneezing, immediately wash your hands with soap and water for at least 20 s. (Wash after cough/sneeze)	□	□	□	□	□
8.After coughing or sneezing, if soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol. (Sanitize after cough/sneeze)	□	□	□	□	□
9.Clean AND disinfect frequently touched surfaces (tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks). (Surfaces)	□	□	□	□	□

Note. Item labels from Table 2 in parentheses.