NF Lax Daily Screener

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Last Name: *

First Name: *

Have you been diagnosed with COVID-19 in the past 14 days? *

Yes

Are you experiencing symptoms typically associated with COVID-19 such as: rash, diarrhea, fever (100.3+), coughing, fatigue, headache, chills, loss of taste/smell, or respiratory distress? *

Yes

Have you been in contact with anyone who has a suspected or confirmed diagnosis of COVID-19 in the past 14 days? *

Yes

Have you taken medicine for a fever or body aches within the past 24 hours? *

Yes

If you have answered "YES" to any of the questions above or your temperature is 100.3 or higher, you are NOT ABLE to participate in today's activities. Please isolate yourself and contact your primary care physician for direction.

By submitting, I certify that all information supplied is accurate and true.

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