COVID-19 Coronavirus - Health Risk Pre-Screening Questionnaire
To prevent the spread of novel coronavirus (COVID-19) in our community and reduce
the risk of exposure to our staff and visitors, we are conducting a simple screening
questionnaire. Your participation is required to help us take precautionary measures to
protect our employees, associates, and visitors from the risks of this virus.
If you answer "YES" to any of the questions below, you are not authorized to enter our facility.
Please contact your host by phone and make alternate arrangements for your business.
* denotes required field