COVID QuestionnairePlease fill out this form no more than 48 hours before visiting YWAM LouisvilleYour Name:* First Last Who Are You Visiting/Reason For Visit* Are you fully vaccinated against COVID-19? (Fully vaccinated means it has been at least two weeks since your final dose.)* Yes No Have you been around anyone who tested positive for COVID-19 in the last two weeks?* Yes No Do you live with the person?* Yes No When were you around them?* Have you been around anyone who has had a fever and/or COVID-19 symptoms in the last two weeks?* Yes No Do you live with the person?* Yes No How long did you spend time with them?* When did you spend time with them?* Do you currently have a fever and/or COVID-19 symptoms?* Yes No Please describe. How long have you had the symptoms?* Have you had a fever and/or COVID-19 symptoms in the last week?* Yes No Please describe symptoms. When did the symptoms occur?* Δ
