Updated: July 7, 2021

WSBA Meeting COVID-19 Screening Questionnaire 


Prior to attending a WSBA Board of Governors meeting or function, please complete and submit this self screening questionnaire. Please respond to each of the following questions truthfully and to the best of your knowledge. Your participation is important to help us take precautionary measures to protect you and other participants from COVID-19.


1. Is your body temperature higher than 400.4 degrees F.?


2. Do you have any of these symptoms that are not caused by another condition?
  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • Recent loss of taste or smell
  • Sore throat
  • Congestion
  • Nausea or vomiting
  • Diarrhea 


3. Within the past 14 days, have you been in close contact with anyone that you know had COVID-19 or COVID-like symptoms?

Close contact is being within 6 feet for 15 minutes or more over a 24-hour period with a person; or having direct contact with fluids from a person with COVID-19 with or without wearing a mask (i.e., being coughed or sneezed on).



4. Do you have a pending or positive COVID-19 test?


5. Are you currently waiting on the results of a COVID-19 test?


6. Have you had a positive COVID-19 test for active virus in the past 10 days?


7. Have you been asked to monitor, isolate, or quarantine because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19?


8. Have you traveled outside the country in the last 14 days?

If you answered "yes," you cannot enter the meeting as we are following the CDC guidelines.

  • Get tested with a viral test three to five days after travel AND stay home and self-quarantine for a full seven days after travel. Even if you test negative, stay home and self-quarantine for the full seven days. If your test is positive, isolate yourself to protect others from getting infected.
  • If you don’t get tested, stay home and self-quarantine for 10 days after travel.
  • Avoid being around people who are at increased risk for severe illness for 14 days, whether you get tested or not.
  • Self-monitor for COVID-19 symptoms; isolate and get tested if you develop symptoms.
  • Follow all state and local recommendations or requirements.


If you answered "yes" to any of the preceding questions, do not attend the meeting in person. If you answered "no" to all of the questions you passed the questionnaire and are clear to come to the meeting/event.




I hereby acknowledge that the responses provided above are true and accurate to the best of my knowledge.



You are welcome to attend the meeting in person. Please wear a face mask and practice social distancing.

You may not attend the meeting in person.