Taking out COVID - NHCC Daily Health Screening
This tool has been developed to support our organization in reducing the risk of transmission of COVID-19 among attendees/staff. The tool is meant to be used to assist with assessing attendees who may be symptomatic, or who may have been exposed to someone who is ill or has confirmed COVID-19. It will also be used for contact tracing in the event of a positive case.

Anyone entering the club must complete this checklist prior to entering the club.

If an individual answers YES to any of the questions, they must not be allowed to enter the club.

*Individuals with fever, cough, shortness of breath, runny nose, or sore throat, are required to isolate for 10 days per CMOH Order 05-2020 unless they receive a negative COVID-19 test and are feeling better. Use the AHS Online Assessment Tool to determine if testing is recommended and follow information on isolation requirements.

As the COVID-19 pandemic continues to evolve, this screening tool will be updated as required.
Today's Date *
Approximate time of entry *
Full Name *
Email Address *
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