Visitor Screening

We aim to ensure the health and safety of everyone working in and visiting the BioSTL Building. Please assist us by completing the following information, which will be kept confidential:

Are you fully vaccinated?

(Must include a booster vaccination.)

Vaccinated YESNO – If no, you must wear a mask while inside the buildingDO NOT WISH TO DISCLOSE – Also in this case, you must wear a mask while inside the building

Regardless of your answer to Number 1 above, please answer the following:

Have you exhibited any of the following symptoms in the past 14 days?

Cough
Shortness of breath or chest tightness
Sort throat
Nasal congestion or runny nose
Loss of taste or smell
Fatigue or body aches
Diarrhea
Nausea
Vomiting
Fever, chills, or sweats

Symptoms YES – If Yes to one or more of the above: We’re sorry. We are currently not allowing anyone with symptoms to visit at this timeNO

Full Name

Name of Person You are Visiting

Date and Time of Visit