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Fall COVID-19 Prescreen
Please meet ASPNC at the venue and check in with the VL when you arrive.
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* Indicates required question
Email
*
Your email
Name- (full first name and first initial of last name)
*
Your answer
If you are accompanying a participant, please name the participant you are accompanying.
Your answer
What Program are coming for?
*
Fall Hiking
Rock Climbing
Golf
Swimming
Other:
Required
Are you currently experiencing any of the following symptoms?
*
Fever, New or worsening cough, Shortness of breath, Lost sense of taste or smell, Nausea, vomiting, diarrhea, Sore throat, Other cold or flu like symptoms
Yes
No
Are you currently waiting for COVID-19 test results, or have you tested positive for COVID-19 in the last 30 days?
*
Yes
No
In the last 10 days, have you been in contact with anyone who has tested positive for Covid-19, are waiting for covid-19 test results, or exhibited any cold or flu like symptoms, such as fever or cough? If yes and you are unvaccinated please quarantine from programming. If you are vaccinated and develop symptoms please quarantine from programming
*
Yes
No
Is anyone in your household currently quarantining or isolating per CDC or Department of Public Health Guidelines?
*
Yes
No
By typing your name below, you agree that the above information is true.
*
Your answer
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