Property viewing Screening Form
Attending with Crissandra Fitzak of Howard Hanna
Name of Person viewing a Property
*
First Name
Last Name
I will be viewing a property located at
blanks
.
Required showing protocal
In the event you become symptomatic and/or test positive for COVID-19 within 48 hours of the last visit to the property, you must notify the real estate agent immediately so proper tracking and tracing can be completed.
Email
example@example.com
Phone Number
*
-
Area Code
Phone Number
Date
*
-
Month
-
Day
Year
Date
Have you knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had symptoms of COVID-19?
*
NO
Yes
Have you tested positive for COVID-19 in the past 14 days?
*
NO
Yes
Have you experienced any symptoms of COVID-19 in the past 14 days?
*
NO
Yes
Have you travelled from a non-contiguous state after 11/4/2020?
*
NO I have not traveled from a non-continuous state
Yes But I have completed the mandatory 14-day quarantine or met the requirements to “test out” of the 14-day quarantine
Yes but I have not quarantined
Submit
Should be Empty: