LT COVID-19 VISITOR SCREENING FORM
*** KESHER STUDENTS: If you are submitting this form for student attending KESHER, please go to the correct form at this link: https://formfaca.de/sm/JQWGS8fF0 ***
This questionnaire must be submitted by all visitors to Larchmont Temple's building or attendees of a physical Larchmont Temple event ON THE SAME DAY they seek to enter/attend (not the day prior; note a new questionnaire must be completed EACH DAY you come).
You must answer “NO” to all the questions in this questionnaire in order to enter our physical location or attend the event. If you answer “YES” to any of the questions, or after you complete this questionnaire but at the time you plan to enter/attend your answer would be "YES" , please DO NOT enter Larchmont Temple's building or attend the event.
If you are answering this questionnaire for multiple people IN YOUR HOUSEHOLD who are accompanying you, you must answer "YES" to a question if any of these people's answers would be "YES".