Achilles Heel – Health Check Form

To support a safe and healthy environment for our weekend Workshop, please take a few moments to complete this COVID-19 Health Check Form before attending this weekend!

Enter your Full Name
First Last
I attest to the following, and am checking these boxes within 48 hours of the start of the in person workshop.*
- I am not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
- I have not traveled internationally within the last 14 days.
- I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
- I have not been diagnosed with Coronavirus/COVID-19 and not yet cleared as non-contagious by state or local public health authorities.
- I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

Achilles Heel – Health Check Form

Insights

Celebrating Your Growth: Transformation Year Long

The Insighter – July 2022

The Insighter – May 2022

The Insighter – June 2022

this is the beginning...