COVID-19 Health Questionnaire

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

PLEASE READ THIS CAREFULLY. Sooner Sensations health questionnaire for in-person rehearsals. Please complete this form no later 1:00 PM on Monday for Monday rehearsals, or 10:00 PM on Friday for Saturday rehearsals. Thank you!

Have you experienced these symptoms in the last 72 hours (Check all that apply, unless the symptom is a normal condition for you)? *

Fever or chills

Fatigue

Coughing or sneezing

Sore throat

Aches and pains

Runny or stuffy nose

Diarrhea

Headaches

Shortness of breath or difficulty breathing

Loss of sense of smell or taste

None of the above

Required

If you would like you can explain your symptoms here.

In the last 14 days, have you been in close contact with anyone who has exhibited the above symptoms? *

Yes

In the last 14 days, have you been in contact with anyone who has tested positive for COVID -19? *

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms