During the last 10 days, have you or anyone you've come into contact with:
Have a fever over 100.3?
Did that person receive a negative Covid-19 at least 4 days after symptom onset?
Tested positive for Covid-19? (Either at the time of contact, or since)
Have you received a negative Covid test at least 7 days after exposure?
Experienced sore throat, trouble breathing, or severe cough?
Did they receive a negative Covid-19 at least 4 days after symptom onset?
I understand that I am required to wear a face mask properly and at all times while inside Birons.
I agree to socially distance where possible while at Birons.
Today's Date
By completing this form you are attesting that all your responses are true to the best of your knowledge.
Please Enter Your Initials Confirming your Acceptance.
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