COVID-19 Monitoring Form - SJN High School

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Please answer the following questions before attending an in-person ministry event with St. John Neumann Youth Ministry!

Email *

Name (First & Last) *

Have you had a fever in the last 24 hours? *

Yes

Have you had a new or unusual cough in the last 24 hours? *

Yes

Have you had a sore throat in the last 24 hours? *

Yes

Have you experienced shortness of breath in the last 24 hours? *

Yes

Have you been in close contact with or cared for someone with COVID-19 in the last 24 hours? *

Yes

Parent Phone Number *

Parent Email *

A copy of your responses will be emailed to the address you provided.

Submit

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