| Date: 08/23/2020 | |
| Do you/they have fever, or have you/they felt hot or feverish recently (14-21 days)? | Yes No |
| Are you/they having shortness of breath or other difficulties breathing? | Yes No |
| Do you/they have a cough? | Yes No |
| Any other flu-like symptoms, such as gastrointestinal upset, headache, or fatigue? | Yes No |
| Have you/they experienced recent loss of taste or smell? | Yes No |
| Are you/they in contact with any confirmed COVID-19 positive patients? Patients who are well but who have a sick family member at home with COVID-19 should consider postponing in person worship. | Yes No |
| Do you/they have heart disease, lung disease, kidney disease, diabetes, or any auto-immune disorders? | Yes No |
| Have you/they traveled in the past 14 days to any regions affected by COVID-19? (as relevant to your location) | Yes No |
Positive responses to any of these would suggest waiting to attend an in-person worship service at St. Anne’s
