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HEALTH QUESTIONNAIRE
These questions are to screen for people who could transmit the virus causing COVID-19. The information will remain confidential and reviewed only by the leader of your group or local clergy. Please fill out this form at least 4 days before you plan to attend a group at Burke UMC. Persons who have 2 or more of the listed symptoms or who have been in contact with anyone experiencing symptoms of COVID-19 in the past 14 days cannot attend at this time.
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