COVID-19 Questionnaire In order to keep our staff and patrons safe, we ask that you take a moment to complete the following questionnaire… COVID-19 Questionnaire Are you feeling unwell with symptoms such as fever, sore throat, cough or shortness of breath?* Yes No Have you traveled overseas in the last 14 days?* Yes No Have you had close contact (face-to-face contact for more than 15 minutes, or have shared an enclosed space for more than two hours) with someone who had a confirmed case of novel coronavirus (COVID-19)?* Yes No Name* First Last Email* Consent* By submitting this questionnaire you are certifying that all of the information provided is true and correct