COVID-19 Questionnaire

Name(Required)
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In The Past 24 Hours, Have You Or Any Other Household Member Experienced:
Cough(Required)
Shortness Of Breath Or Difficulty Breathing(Required)
Fever(Required)
Chills(Required)
Muscle Pain(Required)
Loss Of Taste Or Smell(Required)
Diarrhea(Required)
Sore Throat(Required)
If you answered "yes" to any of the symptoms listed above or a household member's temperature is 100.4°F (38°C) or above your appointment will be rescheduled. It is suggested that you self-isolate and contact your primary care physician's office for direction.

IN THE PAST 14 DAYS, HAVE YOU:
Had close contact with an individual diagnosed with COVID-19?(Required)
Traveled via airplane internationally or domestically?(Required)

If you answered "yes" to either of these questions, your class will be re-scheduled. It is suggested that you self quarantine at home for 14 days.

HVAC U Will Follow Up After A 14 Day Waiting Period To Reschedule If You Need To Quarantine.
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