***PLEASE NOTE THERE HAVE BEEN CHANGES TO THE SURVEY***
Please record your Banc email, today's date, and your location then respond to question 4. If you answer "yes" to question 4 you will be directed to a second set of questions. Please answer thoroughly. 

Question Title

* 1. Banc email, First.Last@bancofcal.com

Question Title

* 2. Today's Date

Date
Time

Question Title

* 3. Location

Question Title

* 4. In the last 24 Hours, have you:

- Had a high temperature and/or felt feverish or chills?
- Developed a new or worsening cough or sore throat?
- Experienced shortness of breath or difficulty breathing?
- Experienced a new loss of taste or smell?
- Experienced out of the ordinary congestion or runny nose?
- Experienced unaccounted muscle pain or fatigue?
- Experienced an unusual or out of the ordinary headache?
- Experienced out of the ordinary digestive issues or diarrhea?
- Had contact or exposure to people or gatherings with COVID-19 in the last 14 days
- Or anyone in your household or company you have been around pending test results because of symptoms of Covid-19?
- Been ordered to isolate or quarantine?

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