Bonnie's Yoga Shala COVID-19 Screening
Updated May 11, 2021 Please fill out this form to screen for COVID-19 interactions and symptoms EACH AND EVERY TIME you come to class. Allow time to complete the form in the hour or so prior to class. You will not be let into the Shala without your form completed and submitted.


Things are improving with more people getting vaccinated. Although we are all under a good light and participate in a safe practice, Your continued cooperation is greatly appreciated, Namaste.
What is your name? *
Which class are you reserving your spot in? *
What is your payment form? *
Have you or anyone in your household and/or pod had any of the following symptoms IN THE PAST 14 DAYS: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit? *
Do you have any reason to believe you or anyone in your household and/or pod has been exposed to or acquired COVID-19 IN THE PAST 14 DAYS? *
To the best of your knowledge have you been in close proximity to any individual who tested positive for COVID-19 IN THE PAST 14 DAYS? *
Have you or anyone in your household and/or pod traveled in the U.S. to a restricted state or internationally IN THE PAST 14 DAYS? (Please reference link to see updated list of restricted states: coronavirus.health.ny.gov/covid-19-travel-advisory ) *
Have ;you had your vaccination *
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