COVID-19 Protocol Form

Please Fill This Out Before Any of Our Services

We are following Baltimore City Guidelines for Worship. Therefore, masks are mandatory while in our sanctuary. Although we can not mandate everyone to be vaccinated to attend our services, we do strongly encourage it for your safety and the safety of others. Upon entry, your temperature will be taken and a series of questions will be asked. If you do not have a mask, one will be given to you upon entry. We do not mandate special seating but encourage that you sit with family or those you come to service with as a precaution.

Full Name

Do you, or anyone attending with you, have any of the following new or worsening symptoms? Symptoms should not be chronic or related to other known causes or conditions.

Fever, chills, or cough; Difficulty breathing or shortness of breath; Sore throat or trouble swallowing; Runny nose/stuffy nose or nasal congestion; Decrease loss of smell and/or taste; Nausea, vomiting, diarrhea, abdominal pain; Not feeling well, extreme tiredness, sore muscles

Have you experienced the symptoms listed above?

Yes

Have you, or anyone attending with you travelled outside of the country in the past 14 days?

Has international travel occured in the last 14 Days?

Yes

Have you, or anyone attending with you had close contact with a confirmed or probable case of COVID-19?

Have you or your guest been in Close Contact?

Yes