Highlander Aquatic and Fitness Center COVID-19 Screening
Please complete the form below prior to visiting the Highlander Aquatic and Fitness Center. A completed form must be in file for admittance to the Highlander Aquatic and Fitness Center.
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Name: *
Phone Number *
Today's Date *
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Current Time *
Time
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In the past 24-hours, have you had any of the following COVID-19 symptoms? *
If you answer yes to any of the following questions, you should not visit the Highlander Aquatic and Fitness Center.
Yes
No
New or worsening cough
Shortness of breath
Difficulty Breathing
Loss of Taste and/or Smell
Fever
In the past 14 days, have you come in close contact with anyone with COVID-19? *
If you answer yes to any of the following question, you should not visit the Highlander Aquatic and Fitness Center.
I certify that I have answered the questions honestly and confirm that I am symptom-free. *
Submit
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