NRG Health Screening Questionnaire
In the interest of safety for yourself, your fellow members and staff - please complete the health screen questionnaire below prior to returning to NRG clubs after COVID-19 closure.
Your full name
Your mobile phone number
Date due to attend
At which club is your membership held?
River Lee, Cork
Xpress, Little Island, Cork
Have you been outside of the Republic of Ireland in the last 14 days?
Have you been in contact with a person with or displaying the symptoms of COVID-19 in the last 14 days?
Do you have now, or have you had in the last 48 hours, any of the following symptoms?
Shortness of breath
Excessive fatigue / tiredness (out of proportion to normal)
None of the above
If any of the above details change, I agree to notify my NRG club as soon as possible.
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This form was created inside of NRG Fitness.