Alumni Event COVID-19 Monitoring Survey Mountainside Alumni Pre-Event SurveyThis survey must be completed prior to attending any Mountainside Alumni EventIf you have any questions please reach out to our Alumni Team by phone at 833-200-6665 or by email at alumniservices@mountainside.comNote: This must be completed by all individual attendees of the event (including guests) Question Title Event Attendee Name Question Title Have you been vaccinated? Yes No Question Title Have you been instructed to quarantine by a medical professional or other official for any reason related to COVID-19? Yes No Question Title IN THE LAST 14 DAYS have you had direct contact (without masks, within 6’ for 15 minutes) with anyone who is COVID positive or is under observation for COVID-19? Yes No Question Title IN THE LAST 48 HOURS have you had a fever of 100.4 or higher? Yes No Question Title Are you experiencing any NEW symptom(s) (see below) that is not due to another health problem? Yes No Symptoms for Question Above• Fever or Chills• Cough• Shortness of breath or difficulty breathing• Fatigue• Muscle or body aches• Headache• New loss of taste or smell• Sore throat• Congestion or runny nose• Nausea or vomiting• Diarrhea Question Title IN THE LAST 7 DAYS have you been tested for COVID? Yes No Next
