COVID-19 Screening Form
Have you screened yourself before entering the church building/office?
· Have you had close contact (within 6 feet for 10-15 minutes over a 24 hour period, per CDC) recently with someone diagnosed with COVID-19 or has any health department been in contact with you and advised you to quarantine?
If you find your answer to this question is Yes, you should not enter the church building/office.
Before entering the church building/office today, have you screened yourself for the items below?
· Fever (100.4 F or higher) or chills?
· Shortness of breath or difficulty breathing?
· New cough?
· Loss of taste or smell?
· Muscle or body aches?
If you have any of these symptoms, go home, stay away from other people, and call your health care provider. If you been diagnosed with COVID-19 or have had symptoms, do not work outside of home until the following:
· 10 days since symptoms first appeared and
· 24 hours with no fever without the use of fever-reducing medications and
· Other symptoms of COVID-19 are improving