COVID-19 Screening Form

Name(*)

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Affiliation: (Company)(*)

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Do you want a copy of this sent to you?(*)

Yes

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Date(*)

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Are you Fully Vaccinated?(*)

Yes

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In general, people are considered fully vaccinated:

2 weeks after their second dose in a 2-dose series, such as the Pfizer or Moderna vaccines, or
2 weeks after a single-dose vaccine, such as Johnson & Johnson’s Janssen vaccine

This information comes from the CDC.