Covid-19 Questionnaire Posted on June 16, 2020August 14, 2020 by Redefine Strength & Fitness Welcome to the Covid-19 Questionnaire on January 19, 2021Your health and well-being are of the upmost importance to us and we are taking measures to keep the Studio a safe environment for members as well as employees during the on-going Covid-19 pandemic. Therefore, we are asking everyone to fill out this questionnaire prior to every training session or class at the Studio. We see this as a way to pause and check in with yourself, not only for your own health and well-being, but also for the health and well-being of others within our community.If you are feeling unwell and/or experiencing possible Covid-19 symptoms, please do not come in for your training session or class!Instead, please contact us at [email protected] or (617) 894-0452 to let us know and we'll treat it as an Early Cancel.If you need to Late Cancel in MBO because you are feeling unwell and/or experiencing possible Covid-19 symptoms, please make a point of letting us know so that we can adjust your session or class in MBO to an Early Cancel so that you don't lose the session or get charged a no-show fee.Please answer the following questions. First and Last Name Email phone number Within the last 14-days, have you experienced a new cough that you cannot attribute to another health condition?YesNo Within the last 14-days, have you had a temperature at or above 100.4° or the sense of having a fever? (We ask that, if you can, to please take your temperature before you answer this question.)YesNo Within the last 14-days, have you experienced a new sore throat that you cannot attribute to another health condition?YesNo Within the last 14-days, have you experienced new shortness of breath or difficulty breathing that you cannot attribute to another health condition?YesNo Within the last 14-days, have you experienced new muscle or body aches that you cannot attribute to another health condition or a specific activity such as physical exercise?YesNo Within the last 14 days, have you had close contact, without the use of appropriate PPE, with someone who is currently sick with suspected or confirmed COVID-19?* (*Note*: Close contact is defined as within 6 feet for more than 10 consecutive minutes)YesNo Within the last 14 days, have you experienced any fatigue that you cannot attribute to another health condition or a specific activity such as physical exercise?YesNo Within the last 14 days, have you experienced a headache that you cannot attribute to another health condition or a specific activity such as physical exercise?YesNo Within the last 14 days, have you experienced any congestion or runny nose that you cannot attribute to another health condition?YesNo Within the last 14 days, have you experienced any nausea or vomiting that you cannot attribute to another health condition or a specific activity?YesNo Within the last 14 days, have you experienced any diarrhea that you cannot attribute to another health condition?YesNoIf you answered YES to any of the questions we ask that you cancel your upcoming appointment. Please cancel your scheduled class or training session in MindBody Online or by contacting us at [email protected] or (617) 894-0452.If you have answered YES to any of these questions and arrive at the Studio, know that we love you AND we will ask you to leave--for the health and wellness of the community and yourself.We also ask that you please fill out the questionnaire prior to arriving at the Studio.If you have answered NO to all of the questions, WOOHOO! We'll see you soon! Time is Up!JOIN OUR NEWSLETTER I agree to have my personal information transfered to MailChimp ( more information )Join our mailing list and join our community. Be the first to know when the latest news, blogs or videos are posted. Receive info about upcoming workshops or where you can join any scheduled events!We hate spam. Your email address will not be sold or shared with anyone else.
