1.  Within the last 14-days, have you tested positive for COVID-19 or have you had close contact (without the use of appropriate PPE) with others who have tested positive? (Note:  Close contact is defined as within 6 feet for more than 10 consecutive minutes)
☐          YES                      ☐          NO

2.  Are you or a member of your household awaiting COVID-19 test results or have you been told to self-isolate?
☐          YES                      ☐          NO

3.  Do you live with someone who is sick at home with bronchitis-like or cold symptoms?
☐          YES                      ☐          NO

Have you experienced within the last 14-days, any of the following symptoms:

4.  Fever (temperature at or above 100.4°) or the sense of having a fever?
☐          YES                      ☐          NO

5.  Chills with shaking or teeth chattering?
☐          YES                      ☐          NO

6.  A sore throat that you cannot attribute to another health condition?
☐          YES                      ☐          NO

7.  A cough that you cannot attribute to another health condition?
☐          YES                      ☐          NO

8.  Shortness of breath that you cannot attribute to another health condition?
☐          YES                      ☐          NO

9.  Pain or tightness in your chest?
☐          YES                      ☐          NO

10.  Flu-like symptoms?
☐          YES                      ☐          NO

11.  Muscle pain that you cannot attribute to another health condition or a specific activity such as physical exercise?
☐          YES                      ☐          NO

12.  Loss of ability to taste or smell?
☐          YES                      ☐          NO

If you answered “yes” to any of the questions above, you should not attend an in-person service.