Evesham Township School District COVID-19 Prevention Building Entry Log for VISITORS
Administration Building
**TO PROTECT EVERYONE FROM COVID-19, ANYONE ENTERING THIS BUILDING MUST ACKNOWLEDGE WHETHER THEY HAVE ANY OF THE SYMPTOMS LISTED BELOW**
Email address *
Sign in with your first and last name: *
Do you have a fever greater than 100? Loss of Taste or Smell? Cough? Sore Throat? Respiratory Illness? Difficulty Breathing? Chills? Muscle Pain? Headache? Congestion? Runny Nose? Nausea? Vomiting? Diarrhea? *
Are you waiting for results of your own Covid-19 test? Have you knowingly been exposed to anyone with Covid-19? *
Which other buildings will you be visiting today? *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Evesham Township Schools. Report Abuse