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Cache Studios | Visitor Health Screening
Please answer the following questions to the best of your ability. Please take note that this is a legal document and it must be completed on the SAME DAY as your class.
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* Indicates required question
Email
*
Your email
Cell Phone #
*
Your answer
Full Name (First & Last Name)
*
Your answer
In the past 10 days have you tested POSITIVE for COVID?
*
No
Yes (if so, entry is NOT permitted)
Yes, but I have since tested negative and am no longer contagious (Proof of negative test must be provided)
In the past 5 days, to the best of your knowledge, have you BEEN IN CLOSE CONTACT (within 6 ft for more than 10 minutes) with anyone that is confirmed positive with COVID-19? (Clinical staff who were in appropriate PPE are not considered close contacts in these scenarios)
*
No
Yes (If so, entry is NOT permitted.)
Have you experienced any symptoms of COVID-19 including a fever of 100.4 degrees Fahrenheit or greater, a new cough, new loss of taste or smell, or shortness of breath with in the past 5 days?
*
No
Yes (If so, entry is NOT permitted).
Are you been fully vaccinated?
*
No
Yes
Have you received your COVID booster?
*
No
Yes
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