Patron Health Questionnaire: Rockaway Borough Public Library

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Name *

Have you tested positive for COVID-19 in the past 14 days? *

Yes

Required

Have you traveled outside of the immediate region of New Jersey in the past two weeks? (immediate region is New York, Connecticut, Pennsylvania, and Delaware) *

Yes

In the past 24 hours, have you experienced nasal or sinus congestion, cough, fever, shortness of breath, or loss of sense of taste or smell? *

Yes

Are any members of your household or close contacts sick with these symptoms? Have you been exposed to anyone suspected of having COVID-19 or with symptoms of COVID-19? *

Yes

I will follow all library rules and regulations and keep myself, the library staff, and others around me safe. *

Yes

Required

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