COVID-19 OFFICE ENTRY FORM August 27, 2020 ELMNT If you are human, leave this field blank.COVID-19 EMPLOYEE AND GUEST ENTRY FORMPLEASE FILL OUT THE FOLLOWING QUESTIONNAIRE IF YOU ARE ENTERING THE STUDIO AND OFFICE SPACES OF ELMNT FM.Name *Date *Time *PhonePLEASE ANSWER THE FOLLOWING QUESTIONS BELOWCOUGH? *YESNOFEVER? *YESNOSHORT OF BREATH? *YESNOSORE THROAT? *YESNORUNNY NOSE? *YESNOLOSS OF TASTE AND SMELL? *YESNONAUSEA, VOMITING OR DIARRHEA? *YESNOHave you been in close contact with someone who is sick or has confirmed COVID-19 in the past 14 days? *YESNOHave you returned from travel outside of Canada in the past 14 days? *YESNOIf you have answered Yes to any of the above questions, please delay your attendance AND contact your healthcare provider, or Telehealth Ontario (1-866-797-0000)Submit