KairosPDX Entry Log
Site Social Distancing Log & Self-Check
Sign in to Google to save your progress. Learn more
*
Please enter today's date *
MM
/
DD
/
YYYY
Please enter your current body temperature: *
What is your destination room number? *
Please enter  your entry time (kindly spend no more than two hours on site to allow time to disinfect between staff) *
Time
:
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kairos Pdx. Report Abuse