OFH Attendance Questionnaire
We love our neighbors and your safety is important to us. To protect the health of all our families and advise of possible exposure, OFH is committed to screening each attendee prior to admittance to in-person indoor meetings.
Email address *
What is your name? *
What is your phone number? *
Only one form per family is required. Please list the names of household members you are providing information on behalf of: *
What is the date of the event you're attending? *
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Have you or anyone in your household experienced 2 or more (out of the ordinary for your health) of these symptoms in the past 14 days: 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, or diarrhea? *
Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19? *
Are you or anyone in your household expecting results from a recent COVID-19 test? *
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