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COVID-19 Check-in

  1. Please answer these questions for every person at check-in.

  2. Have you experienced any symptoms such as shortness of breath, fever, or cough in the past three (3) days?*

  3. Have you exhibited any symptoms of the COVID-19 virus in the past two (2) weeks?*

  4. Have you had exposure to anyone who has exhibited symptoms of the COVID-19 virus in the past two (2) weeks?*

  5. Have you or a family member had exposure to a person with a positive, or pending, COVID-19 test?*

  6. Leave This Blank:

  7. This field is not part of the form submission.