Covid 19 Class Form | Karen Murphy Speech and Drama

Do you have symptoms of cough, fever, high temperature, sore throat, runny nose, breathlessness, loss of the sense of smell / taste or flu like symptoms now or in the past 14 days? *

Have you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days? *

Are you a close contact of a person who is a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2m for more than 15 minutes accumulative in 1 day)? *

Have you been advised by a doctor to self-isolate at this time? *

Please provide details below of any other circumstances relating to COVID-19, not included in the above, which may need to be considered to allow your safe return to Class.

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I confirm that I have answered the above questions truthfully and to the best of my knowledge. I will inform Karen if at any-time in the future I answer yes to any of the above questions. Please enter your email, so we can follow up with you.

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