a. I do not have a temperature greater than 100.4ºF. 


b. To my knowledge, I have not been in close or proximate contact with anyone who has had symptoms of COVID-19 in the past 14 days. 


c. I have not tested positive for COVID-19 in the last 14 days. 


d. I have not experienced symptoms of COVID-19 in the past 14 days, including but not limited to fever or chills, fatigue, difficulty breathing, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea. 


e. I have not attended any events in the last 14 days where social distancing wasn’t observed or masks worn; 


f. I have not traveled internationally or to any domestic virus hot spots in the last 14 days.