COVID-19 SCREENING TOOL

Required Check List

IN COMPLIANCE WITH THE RHODE ISLAND DEPARTMENT OF HEALTH AND REQUIRED BUSINESS REGULATIONS, EACH PERSON ATTENDING ANY WORSHIP SERVICE NEEDS TO FILL OUT THE FOLLOWING FORM.


If you prefer to keep your information confidential, (only the office will have this information) you may choose to print out the pdf below and fill it out at home. However, you must date it and keep it as a matter of record should the RI Dept of Health need it.

IF YOU HAVE ANSWERED “YES” TO ANY OF THE QUESTIONS ABOVE, AND YOU CANNOT EXPLAIN THESE SYMPTOMS BY KNOWN ALLERGIES OR NON-INFECTIOUS ILLNESSES, THEN YOU CANNOT ENTER THIS BUILDING FOR THE SAFETY OF OTHERS. THIS IS IN COOPERATION WITH THE RHODE ISLAND DEPARTMENT OF HEALTH'S GUIDELINES.