Exhibitor Health Screening Questionnaire Name* First Last Phone*Shift Date* Date Format: MM slash DD slash YYYY Shift Start Time* : HH MM AM PM Shift End Time* : HH MM AM PM In the past 24 hours, have you experienced: Fever Fatigue Cough Sneezing Aches and Pains Runny or Stuffy Nose Sore Throat Diarrhea Headaches Shortness of Breath None of the Above Have you recently been in close contact with anyone who has exhibited any symptoms?* Yes No Have you recently been in contact with anyone who has tested positive for COVID-19?* Yes No Have you recently traveled to a restricted area that is under a Level 2, 3, or 4 Travel Advisory according to the U.S. State Department?*Including: China, Italy, Iran and most countries in Europe. Yes No Find a Show By Market Grand Rapids, MI Lansing, MI Detroit, MI Milwaukee, WI