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COVID Questionaire
Please answer the following questions with honesty before registration. We are taking every precaution to maintain a safe environment for our students and staff.
Have you or anyone in your family traveled to countries with high risk of Covid?
Yes
No
Do you or anyone in your family show signs of having a fever, coughing, or trouble breathing?
Yes
No
Did you or anyone in your family come in contact with anyone exposed to Covid?
Yes
No
Are you willing to follow the Center's rules and regulations to maintain a safe environment for all staff and students?
Yes
No
Have you been tested postive for Covid?
Yes
No
Do you have anyone stayingin your household that just came to Houston?
Yes
No
We, parents of student, have read and answered the questions to the best of my knowlwedge.
We, parents of student, understand that there is a risk of exposure to the virus even though the center is taking all precuations to prevent the spread.
We, parents of student, will not hold the Duc Dinh Center accountable for any risk or exposure of the virus on the premises of Duc Dinh Center.
Your Signature
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