LSCC COVID-19 Pre-Screening

All Staff and Volunteers must complete this form no more than 12 hours before participating in LSCC related activities that include potential physical interactions with others.
  • Date Format: MM slash DD slash YYYY
    Contact is being 6 feet (2 meters) or closer for more than 15 minutes with a person, or having direct contact with fluids from a person with COVID-19 (for example, being coughed or sneezed on). 

  • If you answered yes to any of these questions, please do not attend! We will work with you to figure out someone to take your place.

  • This field is for validation purposes and should be left unchanged.