1. Close Contact:

How often in the last 14 days have you ...

1. INDOORS: Been within 6 feet for more than 10 cumulative minutes of anyone indoors, who is not in your household - with anyone NOT properly wearing a mask over their mouth and nose (includes: meetings, shared meals, gaming, working out, visiting friends or family in their home, carpooling or using public transportation)
2. GROUP/INDOORS: Been within 6 feet for more than 10 cumulative minutes with multiple people indoors, who are not in your household - with anyone NOT properly wearing a mask over their mouth and nose (includes: meetings, shared meals, working out at a crowded gym, visiting friends or family in their home, parties, carpooling or using public transportation)
3. OUTDOORS/NOT MOVING: Been within 6 feet for more than 15 cumulative minutes of people outdoors in a stationary environment (not moving around, such as outdoor dining) with anyone NOT properly wearing a mask over their mouth and nose.
4. SYMPTOMATIC ENCOUNTER: Had any encounter in which someone not properly wearing a mask over their mouth and nose was within 30 feet of you and sneezed or coughed on you.
5. INDOORS/MASKS: Been within 3 feet for more than 10 cumulative minutes of anyone indoors, who is not in your household, with you and them wearing only a cloth face covering or standard surgical mask (e.g., not a "protective" mask such as KN-95 or higher grade protective mask)?

2. Surfaces:

How often in the last 14 days have you...

1. Touched your face (or interior of mask) with without first cleaning/sanitizing hands.

3. COVID-19 Symptoms:

In the last 21 days, how many of the following symptoms has ANYONE in your household or bubble had (or anyone in the household you are planning to visit and their bubble):

1. Extreme fatigue (beyond your normal tiredness), nausea, vomiting, diarrhea or intestinal discomfort, shortness of breath or difficulty breathing, cough, sore throat, runny nose/congestion, elevated body temperature of 100.3 degrees (or 1.7-2 degrees above your body`s normal temperature, whatever that may be), unusual or extreme muscle aches or soreness (e.g. outside of normal soreness from working out).

4. COVID-19 Status:

1. In the last 21 days, has anyone in your household OR the household(s) you are planning to visit tested positive for the virus that causes COVID-19, or been concerned anyone in your household or bubble may have been exposed to COVID-19.
2. Have you and your entire household been fully vaccinated for COVID-19, to include the required two week waiting period after receiving the full vaccination dose? (Note that we recommend you confirm vaccination status with ALL parties you plan to visit. If all parties have not been vaccinated, the COVIDSafeVisits screening remains crucial for determining whether it is safe to visit without masks).

5. Personal Health Risk

The CDC has identified a list of underlying medical conditions which can present increased risk of severe illness from COVID-19.

1. Which answer below best describes the risk that you, anyone in your household or anyone you plan to visit may have of experiencing severe illness or other complications from COVID-19 (or any airborne virus) due to underlying medical conditions?

6. Positivity Rate

Visit the website of your local Department of Public Health or the Johns Hopkins University Coronavirus Research Center website to confirm this.

1. What is the COVID-19 "test positivity" rate in your state/county?

7. Your Attitude

1. Which response best represents your personal risk tolerance for becoming infected with COVID-19 (or any airborne virus)?

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