ATU CAMPUS VISITOR 

Health Screening Questionnaire

 

Instructions:

This survey is to be completed the day BEFORE your scheduled campus tour. If you have other persons accompanying you as guests on the tour, please complete the questionnaire on their behalf as well. One (1) questionnaire is to be submitted per party.

 

1. Are you or anyone in your household experiencing any of the following symptoms that are not associated with a chronic or persistent health condition?
(Please select all that apply)
2. In the last 14 days, have you or anyone in your household been in contact with someone who has tested positive for COVID-19?
3. In the last 14 days, have you or anyone in your household been tested for COVID-19?
(If you received a negative test result, please mark NO. If results are pending or you tested positive, please mark YES.)