G2S Coronavirus Disease (COVID-19) Screening

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All visitors (anyone other than enrolled students) must complete this screening form before entering G2S property.

First Name *

Last Name *

Past 24 Hours *

In the past 24 hours have you experienced any of the following symptoms?

Subjective Fever (felt feverish)

Experienced: New or Worsening Cough

Shortness of Breath

Sore Throat

Vomiting/Diarrhea

Loss of Taste or Smell

None of the above

Required

Past 14 Days *

In the past 14 days have you...

Had close contact in the last 14 days with an individual diagnosed with COVID-19?

Engaged in any activity or travel within the last 14 days which fails to comply with the guidance to social distance, mask, and sanitize hands?

Been directed or told by the local health department or your healthcare provider to self-isolate or self-quarantine?

None of the above

Required

G2S Rules *

G2S rules require social distancing, regular hand washing and/or use of hand sanitizer, and a properly worn face covering.

I agree

Face Covering *

I agree to wear a properly worn face covering over my mouth and nose for the duration of my time at G2S.

I agree

Acknowledgment *

If you answered YES to any of these questions and/or have a temperature of 100.4 or higher, you may not enter G2S property until cleared. Please self-isolate and contact your doctor or health department for further guidance.

I hereby attest that the answers I have provided are true and correct to the best of my knowledge.

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