COVID-19 SCREENING & WAIVER

Name(Required)
Your email submitted on this form will only be used in the event you would need to be contacted for contact tracing purposes. We will never market or sell your email address.
Have you or anyone in your household had any of the following symptoms in the last 21 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit?(Required)
*that are not caused by another condition
Have you had a positive COVID-19 test for active virus in the past 10 days, or are you awaiting results of a COVID-19 test?(Required)
Within the past 14 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection?(Required)