Please complete prior to arriving

Pre-screening for 1704 17th St. NE, Washington, DC

If possible, please complete this form at least 15 minutes prior to entering the building.

  • Throughout this form, "you" will refer to the person listed here.
  • :
  • • fever or chills • cough • shortness of breath or difficulty breathing • fatigue • muscle or body aches • headache • new loss of taste or smell • sore throat • congestion or runny nose • nausea or vomiting • diarrhea