Campus Visit Screening Form
We ask that you complete this screening form prior to coming on campus today. Please complete the form at least 30 minutes prior to your scheduled visit time.

All visitors will receive a temperature check upon arrival, in addition to a review of self-screening responses recorded on this form.
Date *
MM
/
DD
/
YYYY
First Name *
Last Name *
Campus Visit Role *
Temperature
If you do not have access to a thermometer prior to your visit, one will be available for your use in the Welcome Center when you arrive.
In the past 24 hours, have you experienced: *
Yes
No
Subjective fever(felt feverish)
New or worsening cough
Shortness of breath
Sore throat
Headache
Repeated shaking with chills
Muscle pain
New loss of smell or taste
New or worsening fatigue
New or worsening running nose and/or congestion
Nausea or vomiting
Diarrhea
In the past 14 days, have you: *
Yes
No
Had close contact with an individual diagnosed with COVID-19?
Traveled via airplane internationally
Thank you! If you answered "no" to all of the questions above, you may proceed to the Welcome Center entrance where a staff member will greet and administer a temperature check.
If you answered "yes" to any of the questions above, please stay home until a member of the McMurry University staff contacts you, assesses your symptoms or status, and approves your visit to campus.
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