The Foundry Covid-19 Visitor Log 2020
The safety of The Foundry community remains our primary concern. As you enter the building, we request that you:
- Wear a mask in common hallways/areas to lower the chance of virus spread
- Maintain social distancing of 6ft per Centers for Disease Control guidelines
- Regularly wash your hands or use hand sanitizer

To help prevent the spread of COVID-19 and reduce the potential risk of exposure to all who come to The Foundry, we are conducting a simple health screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in the building. Please complete this questionnaire prior to entering the building, or immediately as you walk into the main entry. Should you answer YES to any of the following questions, you are instructed to return home immediately, speak to a health professional, and follow up with Foundry staff about your situation.

*Completed forms will be housed in a confidential and secure manner. Only The Foundry's Executive Director and Board President will have access to these files for contract-tracing purposes should the need arise.*

**Please note: We reserve the right to refuse entry of any individual exhibiting symptoms of sickness upon arrival.**

By filling out this form, you are acknowledging the risk of using The Foundry facilities during the Covid-19 pandemic, and agree to enter at your own risk.

Thanks for keeping our community safe!
Email address *
Your First Name *
Your Last Name *
Today's Date *
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Have you or a member of your household had a confirmed case of COVID-19? *
If Yes, please return home immediately and/or speak to Foundry staff about your situation.
Are you or any member of your household under active quarantine due to COVID-19 exposure? *
If Yes, please return home immediately and/or speak to Foundry staff about your situation.
Have you or a member of your household been in contact with anyone who has a confirmed case of, or been exposed to COVID-19? *
If Yes, please return home immediately and/or speak to Foundry staff about your situation.
Have you traveled to/from any domestic destinations currently with a COVID-19 travel advisory, during the past 14 days? Have you traveled outside of the U.S. within the past 14 days? *
If Yes, please return home immediately and/or speak to Foundry staff about your situation.
Are you experiencing any flu-like symptoms such as respiratory distress, cough, fever,or chills? *
If Yes, please return home immediately and/or speak to Foundry staff about your situation.
I am... *
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