COVID Health FormCOVID Health Form Daily screening for COVID-19 symptoms MUST be completed by all persons working the Peninsula Optimist Club Memorial Christmas Tree Sale THE DAY OF your scheduled work shift. For minor participants, this form MUST be completed by a parent or legal guardian.Today's Date* Date Format: MM slash DD slash YYYY Volunteer's Name* First Last Parent/Legal Guardian's Name (if participant above is a minor) First Last Contact Phone*Contact Email* Has participant had a cough or fever in the last 14 days?*YesNoHas participant developed a cough, fever, shortness of breath or other symptoms of COVID-19 in the last 24 hours?*YesNoHas participant experienced a recent loss of taste or smell?*YesNoIs participant in contact with any confirmed COVID-19 positive patients? If yes, please consider postponing tree lot participation.*YesNoMaybeShare this:Click to share on Tumblr (Opens in new window)Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Click to share on Pinterest (Opens in new window)Click to email this to a friend (Opens in new window)
