Self-Testing Questionnaire for Clients and Employees

Please Complete and provide to us this self-testing & disclosure questionnaire within 24 hours
prior to entering the Second Line Stages complex:

1. Have you tested positive for COVID-19 within the last 14 days ?

2. Do you currently have a fever greater than 100°F / 37.8°C ?

3. Within the last 48 hours have you had a fever greater than 100°F / 37.8°C?

4. Do you have a new cough that started or has become worse in the last 48 hours?

5. Do you have shortness of breath that started in the last 48 hours?

*By submitting this form I am confirming that I have read and answer NO to these questions.

(If your answer is YES to any of these questions, please do not submit this form, refrain from entering the studio, and contact a coordinator to reschedule your session)

Thanks for submitting!