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Health Screening Form

Please complete this health screening form 24-72 hours before your in-person visit to Shomrei Torah.

Do not complete a health screening more than 72 hours before your visit.

When you arrive at CST, be prepared to show your confirmation email. 

NOTE: Do not fill out this health survey more than 72 hours before the event you are attending.

  • Fever
  • New Onset Cough
  • New Onset Shortness of Breath
  • Difficulty Breathing
  • Fatigue
  • Muscle/Body Aches
  • Headaches
  • New Loss of Taste/Smell
  • Sore Throat
  • Congestion
  • Running Nose
  • Skin Changes
  • Eye Redness
  • Nausea/Vomiting/Diarrhea
  • Abdominal Pain
  • Feeling Feverish or Measured Temperature Greater Than or Equal to 100.4 Fahrenheit

Thank you for completing our health screening form. Based on your response, we will not be able to accept you on campus for this event.

If you have any questions, call us at (707)578-5519.

Thank you for completing our health screening form. Based on your answers, you are cleared to join us in person!

Please enter your email below so that we can send you a confirmation email. Please bring the confirmation email with you to confirm that you have completed this form.

Your confirmation email will be sent here.
Tue, June 15 2021 5 Tammuz 5781