COVID-19 QUESTIONNAIRE | Opera Holistic Mobil

Do you currently have COVID-19 or any symptoms of COVID-19? *

Yes

No

Have you had COVID-19? *

Yes

No

Does anyone in your household have COVID-19 or symptoms of COVID-19? *

Yes

No

Have you been in close contact with anyone else in the past 14 days who has symptoms of COVID-19

Yes

No

Are you classed as an extremely vulnerable person (high risk)? *

Yes

No

Are you classed as a vulnerable person (moderate risk)? *

Yes

No

Do you agree to adhere to the guidelines in our COVID-19 Policy? *

Yes

No

COVID-19 PRE-TREATMENT QUESTIONNAIRE