Fall 2020 Fine Arts Activity Health Screening Form
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Email address
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Your email
Last Name
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Your answer
First Name
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Your answer
Grade (2020-21)
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Freshman
Sophomore
Junior
Senior
Staff
Gender
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Female
Male
Have you had close contact with an individual who is lab-confirmed with COVID-19? For clarity, close contact is defined as: being directly exposed to infectious secretions (e.g., being coughed on while not wearing a mask or face shield); or being within 6 feet for a cumulative duration of 15 minutes, while not wearing a mask or face shield; if any occurred at any time in the last 14 days at the same the infected individual was infectious.
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Yes
No
Have you recently begun experiencing ANY of the following in a way that is not normal for you? fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea
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Yes
No
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