Health Screening – London Name*Please Select...Takeshi AkiyamaAntony BrocksomRhys BryanHarry CallaghanPatrick GanlathDisha LakhaniDan ShawJames StoneSam TolladayAmar VadherIs your temperature, as measured today, 100.4°F/38°C or higher?* Yes No Are you currently experiencing any of the following symptoms that are not, to your knowledge, caused by another condition: chills; cough; shortness of breath or difficulty breathing; fatigue; muscle or body aches; headache; recent loss of taste or smell; sore throat; congestion; nausea or vomiting; or diarrhea?* Yes No Within the past 14 days, have you been in close proximity with anyone that you know or reasonably believe: (a) has tested positive for Covid-19, (b) had or has Covid-19 symptoms (as described in the preceding question), and/or (c) has been advised by a medical professional or local health official to quarantine due to possible exposure to Covid-19?* Yes No Within the past 14 days, have you been advised by a medical professional or local health official to quarantine due to possible exposure to Covid-19?* Yes No
