COVID-19 Self-Assessment

Anyone planning on coming to church is expected to reflect on these
questions before coming:


Am I over the age of 60 and …?


❏ Do I have existing heart or lung conditions, diabetes, or am I otherwise
immuno-compromised?


❏ Am I currently experiencing any of the following COVID-19 illness symptoms?
o Cough
o Difficulty breathing
o Fever
o Chills
o Muscle pain
o Sore throat
o Loss of taste or smell


❏ Have I been in close prolonged contact with someone confirmed or suspected to
have COVID-19 illness?


If you answer YES to ANY of the three condition questions, please contact your
healthcare provider, and do not return to church yet.