COVID-19 Health Screening Questionnaire As part of our efforts to keep all employees and attendees safe, we ask that you please complete the following health screening questionnaire prior to entering the Annual Meeting. Question Title * 1. Contact Information Name Email Address Phone Number Have you experienced any of the following symptoms of COVID-19 within the last 48 hours? Question Title * 2. Fever or chills Yes No Question Title * 3. Cough Yes No Question Title * 4. Shortness of breath or difficulty breathing Yes No Question Title * 5. Fatigue Yes No Question Title * 6. Muscle or body aches Yes No Question Title * 7. Headache Yes No Question Title * 8. New loss of taste or smell Yes No Question Title * 9. Sore throat Yes No Question Title * 10. Congestion or runny nose Yes No Question Title * 11. Nausea or vomiting Yes No Question Title * 12. Diarrhea Yes No Question Title * 13. Have you tested positive for COVID-19 in the last 10 days? Yes No Question Title * 14. Are you currently awaiting results from a COVID-19 test? Yes No Question Title * 15. Have you been exposed to someone with COVID-19 in the last 14 days? Yes No NOTE: If an individual answers “YES” to any question above, when applicable, the individual should not be admitted before receiving a negative COVID-19 test onsite. Individuals with symptoms or who test positive for COVID-19 should be advised to leave and to contact their physician. Question Title * 16. Please initial here: Submit