Covid-19 Questionnaire

Name Please enter your name

Telephone We'll never share your Telephone with anyone else.

Email address We'll never share your email with anyone else.

Do you have any of the following flu like symptoms? Fever, New dry cough, sore throat, Headache, body aches, shortness of breathe

Have you had both of your Covid-19 vaccinations?

Have you or anybody you have been in contact with, been tested positive for Covid-19 in the past 14 days?

Have you had a Covid-19 test and are currently awaiting results?

Have you travelled abroad in the last 14 days?