Stars VB Covid-19 Screening
Name *
Name *
Temperature *
Symptoms *
Do you have any or have had any of the following symptoms within the last 24 hours?
Close Contact *
Have you been in close contact with someone with COVID-19?
Exit *
I will exit this screen from my phone after submitting
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy