Forms | the LAB

top of page

Use tab to navigate through the menu items.

COVID-19 Symptom Checker Questionnaire

Is your Explorer feeling healthy enough for their upcoming Adventure?

Name

Explorer's Name

Email

Explorer does not have a fever

Explorer is not experiencing any of the followoing unexplained symptoms: cough, sore throat, loss of taste or smell

Explorer has not been tested positive or been in close contact with anyone who has tested positive for COVID-19 in the past 14 days

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Loudoun County, Virginia

Use tab to navigate through the menu items.

bottom of page