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Non-Alpine COVID-19 Prescreen
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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
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 already tested positive?
*
Yes
No
Have you or anyone you are in contact with 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?
*
Yes
No
Have you traveled outside of New England in the past 14 days?
*
New England includes: New Hampshire, Massachusetts, Vermont, Maine, Rhode Island and Connecticut.
Yes
No
By typing your name below, you agree that the above information is true.
Your answer
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