COVID-19 Questionnaire

First Name Required

Last Name Required

Company Required

Phone Number Required

Email Required

I am currently experiencing a fever (greater than 100.4 F or 38.0 C) Required

Yes

No

I have one or more symptoms associated with COVID-19. Required

Yes

No

I have been in contact with someone in the last 5 days who has been confirmed positive for COVID-19 Required

Yes

No

I am waiting for the results of my own COVID-19 test. Required

Yes

No

By clicking below, I signify my understanding that due to Mayor Carter's 2022-02 executive order, face coverings are required for all businesses in St. Paul, with the exception of periods of eating and drinking. Required

I understand.

Submit