Your name, phone number, and email are stored for at most a month for contract tracing, so that we may contact you should we discover any positive cases of COVID-19 in our building.
Have you been in close, physical contact (6 feet or closer for at least 15 minutes) with anyone who has tested positive for COVID-19 within the last 10 days?
COVID Test Results
Sore throat?New cough (not related to any chronic conditions)?New nasal congestion or runny nose (not related to allergies)?Muscle aches?New loss of smell?New loss of taste?Shortness of breath?
Do you attest to answering this Screening Survey honestly and accurately to how you are feeling at the current time?
5601 W Slauson Ave., Suite 243
Culver City CA 90230
T 310 774 0555
Copyright © ReKon