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Welcome To E3RC
Welcome To E3RC
Please fill out the following information before you come in today.
13Questions
E3 COVID-19 Self Screening Questionnaire
  • 1
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  • 2
    Please enter your Robotics Team Number
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  • 3
    Pick a Date
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  • 4
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  • 5

    You must answer “NO” to all the questions in this questionnaire in order to enter our physical location. If you answer “YES” to any of the questions, please DO NOT come enter the company’s buildings.

    If you experience any symptoms or answer “YES” to any of these questions, you must immediately contact your health care professional for recommended next steps AND notify your coach and E3RC Staff

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  • 6

     

    In order to remain open to in-person visitors, per the State of Indiana, all people must wear a face covering at all times when another person is present. 
    This should be a minimum of a cotton mask or a full face shield.  

    If you need a mask they are available for $1.00

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  • 7
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  • 8
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  • 9
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  • 10

    If you answered “Yes” to question one, please DO NOT come into E3. You should:

    • Self-quarantine for at least 10 days from the date on which you first experienced any of the above symptoms; AND
    • Wait until you have had no fever for at least 3 days (without the use of fever-reducing medication) AND
    • Improved respiratory symptoms (no cough, shortness of breath)
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  • 11
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  • 12

    If you answered “Yes” to any part of question two, please DO NOT come into E3. You should self quarantine for at least 14 days.

    I certify to the best of my knowledge; this information is accurate.

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  • 13
    Clear
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