Best Light COVID-19 pre-session safety checklist
This is for safety and contact tracing to be filled out 2 HOURS prior to your appointment.  DO NOT FILL OUT ANY SOONER THAN THAT.  Thank you.
Prijava v Google, če želite shraniti napredek. Več o tem
E-poštni naslov *
Name (first and last) *
Have you been diagnosed with COVID-19 at all? *
Have you had a cough, fever, sore throat, "fickly" throat, nausea, shortness of breath, or loss of smell or taste in the last 2 weeks? *
Has anyone in your germ pool (people you are around without masks) EVER been diagnosed with COVID-19? *
Have you been exposed to anyone who suspects they may have COVID-19 within the last 2 weeks (inside or outside of your germ pool, with or without a mask)? *
Are YOU ALWAYS wearing a mask when in contact with ANYONE outside of your germ pool?  This includes grocery stores, places of worship, workplaces, with friends or family, and ALL PUBLIC SPACES. *
Are ALL OTHER PEOPLE IN YOUR GERM POOL ALWAYS wearing a mask when in contact with ANYONE outside of your germ pool?  This includes grocery stores, places of worship, workplaces, with friends or family, and ALL PUBLIC SPACES. *
Are you high risk?  That means that you are over age 60 or possess health issues that increase your risk (immune system issues, active cancer and/or chemotherapy, heart issues, lung issues, etc.).   *
Anything to add or ask?
Pošlji
Počisti obrazec
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