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CHEF’S SPECIAL GUEST HEALTH FORMNAME:DO YOU HAVE ANY OF THE FOLLOWING SYMPTOMS: FEVER, CHILLS, DIFFICULTY BREATHING, NEW LOSS OF TASTE OR SMELL, VOMITTING, PERSISTENT HEADACHE, NEW OR WORSENING COUGH, SORE THROAT, WHOLE BODY ACHES?HAVE YOU VISITED ANY OF THE FOLLOWING STATES WITHIN THE LAST TWO WEEKS?Alabama, Arkansas, Arizona, California, Florida, Georgia, Iowa, Idaho, Louisiana, Mississippi, North Carolina, Nevada, South Carolina, Tennessee, Texas, Utah HAVE YOU BEEN IN CONTACT WITH SOMEONE WHO HAS TESTED POSITIVE FOR COVID-19 IN THE PAST TWO WEEKS? IF YOU SAID YES TO ANY OF THE ABOVE AND/OR HAVE A TEMPERTURE OF ABOVE 100 DEGREES FAHRENHEIT, PLEASE CHECK IN WITH THE HOST. GUEST TEMPERATURE:17999085270550149121768482000250176848 (SIGNATURE) (DATE) ................
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