Daily Health Screening

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Email *

Name *

Phone number *

Member ID# *

Have you or any one in your household have COVID-19 symptoms in past 14 days? *

Yes

Have you or any one in your household have a positive COVID-19 diagnostic test in past 14 days? *

Yes

Have your or any one in your household have close contact with confirmed or suspected COVID-19 case in past 14 days; and/or traveled within a state with significant community spread of COVID-19 for longer than 24 hours within the past 14 days? *

Yes

Thank You!

You have completed the YMCA Health Screening . If you answered yes to any of the following questions we asked that you do not enter the facility.

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