covid questionnaire

PCM COVID-19 Questionnaire

View below a preview of the PCM COVID-19 Questionnaire.

Last updated November 30, 2020.

In order to better assure the safety of our church community, we ask that you review these questions 24-hours before your visit and complete the questionnaire; then confirm with your meeting coordinator that you have done so prior to arriving for your meeting.

If you are in any of the ‘high risk’ categories defined by the CDC, we urge you to consider attending the meeting virtually (online) or by telephone rather than entering the building.

If you answer ‘YES’ to one or more of the following questions, you may not enter a PCM facility.

  1. Have you or anyone in your household tested positive for COVID-19 (within the last 14 days) or is awaiting results of a COVID-19 test? If you tested positive, you must wait 10 days after the point when symptoms first appeared and be at least 24 hours with no fever without the use of fever-reducing medications and other symptoms of COVID-19 are improving or have received a negative result from -2 subsequent tests in a row at least 24 hours apart.
  2. Do you or anyone in your household have any of the following symptoms?
    • Fever over 100.4 degrees
    • Cough
    • Sore throat
    • Headache
    • Nasal congestion or runny nose
    • Shortness of breath or difficulty breathing
    • Fatigue; unexplained muscle or body aches
    • Loss of taste or smell
    • Nausea, vomiting, or diarrhea
    • Repeated shaking with chills
  3. Have you or anyone in your household returned from international travel within the past 14 days or territory beyond the immediate region (New York, Connecticut, Pennsylvania, and Delaware) within the past 14 days?
  4. In the past 14 days, have you or anyone in your household had close contact with someone who has tested positive for COVID-19 or exhibited COVID-19 symptoms (as defined above)? Close contact means being within 6 feet for more than 10 minutes.

Thank you very much for your cooperation.

Last updated November 30, 2020.