SLAC COVID-19 Check-In Form

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Please fill this out on the day you plan to come to SLAC, before each time you visit.

Email *

Full name you used to sign up for lesson/open *

Reason for Visit *

Are you currently experiencing any of the following new or worsening signs or symptoms of possible COVID-19? *

yes

Cough

Shortness of breath or difficulty breathing

Chills

Muscle pain

Headache

Sore throat

Loss of taste or smell

Diarrhea

Feeling feverish or a measured temperature greater than or equal to 99.6°F

If you answer “yes” to any of these questions, you will not be allowed entry into SLAC today. We recommend self-quarantine at home for 5 days.

Self-quarantine at home and contact your primary care physician’s office or nearest urgent care facility for direction.

You should isolate at home for a minimum of 5 days since symptoms first appear.
You must have 1 day without fever (without the use of fever-reducing medications) and improvement in respiratory symptoms before you come to SLAC.

In the past 5 days, have you had close contact with an individual who has tested positive for COVID-19? *

Close contact is defined as any exposure that takes place within 6 feet for a cumulative total of 15 minutes or more over a 24-hour period.

yes

If you answer “yes” to the above question, you will not be allowed entry into SLAC today. We recommend self-quarantine at home for 5 days.

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