COVID-19 Screening Questions
Coronavirus Disease (COVID-19) has been reported in every state and in countries around the world. COVID-19 can cause respiratory illness.
In order to protect you and others, we are asking about symptoms and exposure to COVID-19 before you participate in this group activity.

Please answer the following questions:
Email address *
Name *
Trip Location *
Trip date *
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Do you have a fever? *
Do you currently have cough or shortness of breath? *
In the past 14 days, have you (or someone in your household) traveled internationally or domestically? *
In the past 14 days, have you or someone in your household been diagnosed, tested or quarantined under doctor’s orders for COVID-19? *
In the past 14 days, have you been in close contact with someone who has been diagnosed, tested or quarantined under doctor’s orders for COVID-19? *
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