Visitor Screening Form

 

Each visitor must fill out one form to document time of entry, symptoms and vaccine status. Thank you for helping us keep our community safe!

Answer the questions below:

Do you have a cough?(Required)
Have you experienced shortness of breath?(Required)
Do you have a headache?(Required)
Have you lost your taste or smell?(Required)
Have you had exposure to COVID-19 in the last 14 days?(Required)
Have you traveled outside of the U.S.A?(Required)
Have you had your COVID-19 vaccine?(Required)
I agree to abide by the following visitation guidelines:(Required)