Volunteer Health Screening

Instructions

ALL VOLUNTEERS must be asked the following below, within 24 hours of coming to camp. This record will be kept for 14 days from completion of this form and this form is available upon request from the Public Health Department.
If YES to any, you will not be allowed to come to Camp Chinquapin at this time. - If NO to all, proceed to remaining questions
If YES, you will not be allowed to come to Camp Chinquapin at this time. - If NO, proceed to question 4.
If YES, you will not be allowed to come to Camp Chinquapin at this time. If NO, we look forward to seeing you soon.
If you are doing this screening for someone other than yourself, please note above