COVID Self Assessment Form
The safety of our AADians and Board is our main priority. As the coronavirus (COVID-19) pandemic continues, we are monitoring the situation closely and following guidance from the Centers for Disease Control and Prevention and local health authorities.
In order to prevent the spread of the coronavirus and reduce the potential risk of exposure to our AADians and Board, we are asking all who are coming to our Deaf club to complete this online self-assessment prior to arrival. This online self-assessment must be completed before entering the building.
Please respond to each question in the assessment truthfully and to the best of your ability. Your participation is important to help us take precautionary measures to protect everyone in our Deaf community.
Please note: If you click "YES" to this question, please do not come to the AAD premise. You also will be contacted by someone from Austin Deaf Club Board.
What is your FULL name?
Text number (if prefer than email)
Disclaimer: Do you understand that AAD is not liable if you become sick and this is considered your waiver? Please put your name initials here
Send me a copy of my responses.
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