These questions are to screen people who could transmit the virus causing COVID-19. The information will remain confidential and reviewed only by the pastor(s), the healthy church team, or the Department of Health for possible contact tracing. Persons who have 2 or more of the listed symptoms or who have been in contact with anyone experiencing symptoms of COVID-19 in the past 14 days are encouraged to worship online only.
A Vine Church (COVID-Safe) Event
Children's & Family Event (COVID-Safe)
Fever, feeling hot, feverish
Shortness of breath, difficulty breathing
Flu-like Symptoms: diarrhea, intestinal upset, or fatigue
Recent loss of taste or smell
Please check any of the following symptoms you are experiencing, or have experienced
during the past 14 DAYS:
I have tested positive for COVID-19 in the past 14 days
I have tested negative for COVID-19
If I test positive for COVID-19; I will let pastor(s) know
I have or had symptoms and are waiting on results.
Yes, I did bring children.
No, I did not bring children
I affirm we share the same response to the questions above.