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SLAC Check-In Form
Please fill this out on the day you plan to come to SLAC, before each time you visit.
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* Indicates required question
Email
*
Your email
Full name you used to sign up for lesson/open
*
Your answer
Reason for Visit
*
Choose
Open Practice/Flex Time
Series Class
Private Lesson
Drop-In Class
Beginner Trial Class
Workshop
Other
Are you currently experiencing any of the following new or worsening signs or symptoms of possible COVID-19?
*
yes
no
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
yes
no
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 for a cumulative total of 15 minutes or more over a 24-hour period.
yes
no
If you answer “yes” to the above question,
you will not be allowed entry into SLAC today. We recommend self-quarantine at home.
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