Copy of BIAV COVID-19 Questions Question Title * 1. Name Question Title * 2. In the past 48 hours have you had:a. Any cough, shortness of breath, difficulty breathing, or new loss of taste/smell?b. Fever of 100.4 or higher, chills, or body aches?c. Headache, sore throat, GI symptoms (e.g. nausea/vomiting/diarrhea), or runny nose/congestion?d. Have you had a positive COVID-19 test in the last 10 days?e. Are you waiting on a COVID-19 test result for reasons other than pre- procedure/surgery? Yes No Question Title * 3. Have you been exposed to anyone with COVID-19 in the last 14 days? Yes No Question Title * 4. Have you traveled internationally or been on a cruise in the last 14 days? Yes No Question Title * 5. If I am able to attend, I agree to follow all rules established by the health committee of BIAV to ensure the safety of our community. This includes using hand sanitizer or washing my hands with soap and water upon arrival, and wearing a mask at all times that extends from below my chin to the bridge of my nose. Yes No Done