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COVID-19 Entry Form
As part of government guidance we have been asked to collect details of all our patrons. Please help us to control the virus and protect the NHS
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Have you experienced any cold or flu-like symptoms in the last 14 days? (such as fever, cough, sore throat, runny nose, respiratory illness, difficulty breathing)
Yes
No
Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?
Yes
No
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Have you recently been in close contact with anyone who has exhibited any cold or flu-like symptoms?
Yes
No
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Are you deemed vulnerable / “at risk”?
Yes
No
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Do you reside with someone who is shielding, isolating or who is considered “at risk”?
Yes
No
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If you have answered yes to any of the above please visit
https://www.gov.uk/coronavirus
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