RHI COVID-19 Prerequisite Screening
Please complete this screening form before arriving on site at the RHI building or Red Hook Farms
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Name *
Phone Number
Department, or Volunteer?
Are you fully vaccinated? *
Have you experienced a fever of 100.4 degrees Fahrenheit or greater, a new cough, sore throat, runny nose, fatigue, or shortness of breath within the past 10 days? (If you answered YES please stay home) *
To the best of your knowledge, in the past 5 days, have you been in close contact (within 6 feet for at least 10 minutes) with anyone while they had COVID-19? (If you answered YES please stay home) *
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