Covid-19 Pre Screening Please fill out the questions below to expedite your entry into The Alaska Club. Name* First Last Email* Have you been diagnosed with COVID-19 or tested positive for COVID-19?*YesNoIf you been cleared to discontinue quarantine since your positive test or diagnosis, please select No.Have you had any COVID-19 symptoms in the past 72 hours and not been evaluated by a health care provider?*YesNoA) New onset fever or chills. B) Nausea, vomiting, or diarrhea C) Persistent cough D) Loss of taste or smell E) Shortness of breath F) Sore throatDo you currently have a fever of 100.4 or greater?*YesNoWithin the last 14 days, have you had close contact* with a person who tested positive or presumed positive by a doctor and has not been cleared to discontinue quarantine by either a public health agency or their medical professional? If you are a medical professional who has had close contact within your place of work while wearing appropriate PPE, please select "No."*YesNoClose contact is defined by the CDC as contact with: 1) a householder member, 2) intimate partner, 3) individual providing care in a household without using recommended infection control precautions or 4) 15 minutes within 6 feet proximity of the individual within a 24 hour period. Consent* I fully understand and appreciate both the known and potential dangers of utilizing the facilities, services, and programs of The Alaska Club and acknowledge that use thereof by the undersigned may, despite The Alaska Clubs reasonable efforts to mitigate such dangers, result in the exposure to COVID-19.SORRY, YOU ARE NOT ALLOWED TO ENTER THE ALASKA CLUB AT THIS TIME. EmailThis field is for validation purposes and should be left unchanged. Δ
