Mais Oui Villa COVID19 Guest Screening Tool

Each guest staying at Mais Oui Villa will need to complete this form. Parents may complete this for for each of their children staying with them. We recommend completing this form honestly and accurately prior to your travel. This will help prevent an unfortunate event such as your being removed from the villa to be quarantined by the Jamaican Ministry of Health at a location designated by them.

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* 1. Address

Name

Flight Number

Address

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Arrival Date

Enter Arrival Date

Date

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* 3. Within the past 14 days, I have had fever (body temperature above 100.4), cough, shortness of breath, sore throat, diarrhea or changes in smell or taste.

Yes

No

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* 4. Within the past 14 days, I have been in close contact with someone who is COVID19 positive or has symptoms of COVID19

Yes

No

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* 5. Within the past 14 days I have been under observational quarantine for COVID19 risk.

Yes

No

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* 6. Within the past 14 days, I have tested positive for COVID19

Yes

No

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* 7. Local Residents Only: Within the past 14 days I have traveled abroad

Yes

No

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* 8. I understand the need for social distancing, frequent handwashing and that staff may wear face masks and/or gloves to reduce risk of spread of COVID19 and other viral illnesses.

Yes

No