COVID-19 Pre-Tour Survey
Visitor Name: ___________________________
Thank you for your interest in The Sylvia Apartments. Due to the COVID-19 pandemic, we are taking additional precautions to help protect the health and safety of our residents and visitors. A tour will include the unit and common areas. Visitors may come into contact with residents and staff.
Prior to the tour, please complete the following survey:
I knowingly and willing consent to tour the premises during the COVID-19 pandemic.
ð By checking this box, I understand and accept the above statement.
Have you or anyone in your party shown any symptoms (coughing, shortness of breath, fever) of COVID-19 in the last 14 days?
ð Yes
ð No
Have you or members of your household been exposed to confirmed COVID-19 cases in the last 14 days?
ð Yes
ð No
Are you willing to wear a mask or face covering and gloves while on the tour? If you do not have your own mask, face covering, and/or gloves we will provide them for you.
ð Yes
ð No
To the extent possible, are you willing to maintain six feet of physical distance from any staff and/or residents while on the tour?
ð Yes
ð No
Please note, if you are showing COVID-19 symptoms, have been exposed to COVID-19, or are unwilling to use a mask or face covering and gloves or maintain physical distance, we will be unable to offer you a tour.
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Visitor Signature Date
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Staff Signature Date