SWAEC VISITOR COVID QUESTIONNAIRE
You must fill out this form before arriving for your fingerprinting appointment.
Email address *
Date *
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First and Last Name *
I have had a fever of 100.4°F within the last 14 days. *
I am experiencing at least one of these symptoms: cough, shortness of breath, respiratory infection, sore throat, loss of sense of taste or smell. *
I have had contact with someone that has lab-confirmed Novel Coronavirus within 14 days of symptom onset. *
I have traveled outside my city of residence or outside the state of Arkansas in the last 14 days. If you answer yes, please list the city visited in the question below. *
I have visited the following city or state:
I verify that the above information is true. *
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