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?
Do you or anyone in your family show signs of having a fever, coughing, or trouble breathing?
Did you or anyone in your family come in contact with anyone exposed to Covid?
Are you willing to follow the Center's rules and regulations to maintain a safe environment for all staff and students?
Have you been tested postive for Covid?
Do you have anyone stayingin your household that just came to Houston?

Your Signature

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11810 Bellaire Blvd. Ste. D |  DucDinhCenter.net  |  Tel. 832-526-9378

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