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.
Email address *
Your full name *
Your mobile phone number *
Date due to attend *
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DD
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At which club is your membership held? *
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? *
If any of the above details change, I agree to notify my NRG club as soon as possible. *
Required
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