JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
COVID-19 check in form
Please fill out this form to the best of your knowledge. By submitting this form, you agree to be contacted in the event of emergency related to COVID-19 contact tracing. Thank you for your cooperation.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
I can confirm that I have no COVID symptoms prior to entering the gallery or been in close contact with any person with a confirmed case of COVID-19
*
Yes
No
Required
Last name
*
Your answer
First name
*
Your answer
email address
*
Your answer
Your best phone number
*
Your answer
Which gallery did you attend?
*
Ohio University Art Gallery, Seigfred Hall
Trisolini Gallery
Date of attendance
*
MM
/
DD
/
YYYY
Time that you came to the gallery
*
Time
:
AM
PM
Approximate duration that you were in the gallery
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
