Health Screening
Daily health screenings are taken from New Hampshire's Universal Guidelines and must be complied with while using the North Conway Community Center. Please be honest and accurate when answering questions. Failure to report symptoms or exposure may result in suspension from the program or ineligibility to participate in future programs of the North Conway Community Center. If you or your child answers yes to any of the questions for your child, please do not come to the center today.
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First Name *
Last Name *
Symptoms of COVID-19:
-Fever (a documented temperature of 100 degrees Fahrenheit or higher) or are feeling feverish
-Respiratory symptoms such as a runny nose, nasal congestion, sore throat, cough, or shortness of breath
-General body symptoms such as muscle aches, chills, and severe fatigue
-Gastrointestinal symptoms such as nausea, vomiting, or diarrhea
-Changes in sense of taste or smell
Have you/your child had any symptoms of COVID-19? *
(Note: healthcare workers caring for COVID-19 patients while wearing appropriate personal protective equipment are not considered to have a close contact exposure in regards to the following question)
Have you/your child been in close contact with someone who is suspected or confirmed to have had COVID-19 in the past 10 days? *
Have you or your child traveled internationally (outside of the U.S., except for essential travel to/from Canada) or by cruise ship in the prior 10 days? *
Do you have a fever? (Temperature above 100 degrees F) *
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