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Health Screening Questionnaire

    Oct 20, 2020 | by Mike Prah

    Health Screening Questionnaire

    The health and safety of our members and guests is our top priority. We ask everyone who attends our Services or visits our Church to provide information regarding any symptoms of, or exposure to COVID-19, with this simple screening questionnaire. Please complete all required sections for each household member attending our service. Thank you. Health Screening PDF Form

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    1. Have you tested positive for COVID-19 or are you waiting on the results of a COVID-19 test?

    Response Required*

    If your answer is "Yes," please worship with us online.

    2. Are you isolating or quarantining because you may have been exposed to a person with COVID-19 or are concerned that you may have contracted COVID-19?

    Response Required*

    If your answer is "Yes," please worship with us online.

    3. Have you come into close personal contact with someone who tested positive for COVID-19 within the last 5 days?

    Response Required*

    If your answer is "Yes," please worship with us online.

    4. Have any of these symptoms begun in a new or unusual way in the past 48 hours: Fever, chills, cough, nausea, diarrhea, sore throat, runny nose, vomiting, difficulty breathing, fatigue, head/body aches, loss of smell/taste?

    Response required*

    If your answer is "Yes," please worship with us online.

    5. Have you received the COVID-19 vaccine?

    Optional

    If you are experiencing symptoms or answered YES to Questions 2 through 5 above, please DO NOT ATTEND our in-person Church Service. Contact your doctor for direction and watch our service online.

    • Face masks are OPTIONAL for persons attending our Church service. 
    • Feel free to continue to wear a mask if you feel comfortable.
    • While masks are optional, please be kind to those who choose to wear a mask and respect everyone's personal space.
    • If you have tested positive for COVID, please worship with us online. You may return to in-person worship after at least 5 Days have passed since your symptoms began and you are fever-free for at least 24 hours without the use of fever reducing medications.
    • If you are experiencing any of these symptoms in a new or unusual way in the past 48 hours (Fever, chills, cough, nausea, diarrhea, sore throat, runny nose, vomiting, difficulty breathing, fatigue, head/body aches, loss of smell/taste), please worship with us online.
    • Face masks will be provided at our lobby for anyone who needs it.

    Thank you for your cooperation in helping all of us stay safe and healthy. God bless you

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