Pre- trip Health Screening Document
We appreciate you taking the extra diligence to sign this pre-trip health screening 72 hours before departure. We view this as the first way you are beginning to care for and serve your team, our sites, and your host community. Our intent is that your trip is safe for everyone involved.
Please read carefully and sign within 72-hours prior to departure:
· I have not been diagnoses with COVID-19 in the last 21 days.
· I have not experience any of the following symptoms in the past 14 days (excluding pre-existing conditions)
o Temperature of 38 C/100.4 F or higher
Cough
Shortness of breath/difficulty breathing
Chills
Muscle pain
Sore throat
Recent loss of taste or smell
· I have not had contact with anyone who has tested positive for COVID-19 in the last 14 days
· I tried to limit my exposure to large groups of people 2 weeks prior to my trip.
· I agree to follow all local guidelines and safety protocols put in place by the host site leadership. Including, but not limited to, the wearing of face covering, daily health screening protocols, and ministry specific precautions, or any other protocols put in place at the host site.