SARS-CoV-2 Detection in the Urban Environment
Sign-up application to do environmental sample collection.
Please use your Google e-mail address (Gmail or G Suite e-mail address).
Email address *
Full Name *
Phone Number *
Street Address (Street, City, State, Zip) *
Have you worked with hazardous materials previously? *
Are you comfortable wearing personal protective equipment (gloves and a facemask) while working with caustic and hazardous chemicals? *
Do you acknowledge that you are aware that you can not collect human samples and that no human samples will be processed by our laboratory? *
What region in San Diego do you anticipate sampling? *
What size gloves do you wear? *
I am voluntarily participating in this Activity. I understand that there are risks associated with my participation in this Activity, such as physical and/or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability, death or economic loss. These injuries or outcomes may arise from my own or other’s actions, inactions, or negligence, or the condition of the Activity location (s) or facility (ies). Nonetheless, I assume all risks of my participation in this Activity, whether known or unknown to me, including travel to and from the Activity or any events incidental to this Activity. *
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