COVID-19 Screening Check-In


If you prefer a paper copy, please download, print and complete this form and bring it with you on your visit. A copy of the form can be found here: COVID-19 Screening Paper Copy

Your Information

Please use this form on the day you plan on visiting or entering the church premises. Each person in your family is required to fill out and submit an individual form.

Screening Questions

If you answer "Yes" to any of these questions or have checked off any of the symptoms listed, please stay home and self-isolate immediately. Call TELEHEALTH (1-866-797-0000) or your health care provider to find out if you need to be tested for COVID-19.

Confirmation and Acknowledgement


Related Information