Hale Expo Services
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Hale COVID-19 Tracking Form
Have you had close contact with anyone that has a confirmed or suspected COVID-19 case in the past 14 days?
Have you had a positive COVID-19 test in the past 14 days?
Have you had any COVID-19 symptoms in the last 14 days? (copy)
If you answered yes to having COVID-19 symptoms, please answer
Shortness of Breath or Difficulty Breathing
Cough (new onset or worsening)
Fever (felt feverish or warm)
Sore or Scratchy Throat
Loss of Taste or Smell
Check all that apply
Have you been out of New York State?
If you have been out of state, please indicate the state you visited
Please initial to testify to the truth of your response