Casco Bay Kayak COVID-19 Questionnaire

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Per the Governor of Maine's executive order business are required to confirm some information to help us prevent the spread of COVID-19. Thank you for your help and cooperation

Email *

From what State are you traveling? *

Have you Quarantined for 14-days or do you have a negative COVID-19 test result? *

If you live in New Hampshire, Vermont, Connecticut, New Jersey or New York please choose exempt state.

Quarantine

Test

Exempt State

On what date did you arrive in Maine or on what date was the COVID-19 test performed?

YYYY

Have you had a cough or sore throat? *

Yes

Have you had a fever or do you feel feverish? *

Yes

Do you have shortness of breath? *

Yes

Do you have a loss of taste or smell? *

Yes

Have you been around anyone exhibiting these symptoms within the past 14 days? *

Yes

Are you living with anyone who is sick or quarantined? *

Yes

Send me a copy of my responses.

Submit

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