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Check-in Form

  1. Are you waiting in a vehicle?*

  2. Are you a(n): *

  3. Reason for your visit to the Court (please select)*

  4. Self Screening

  5. Do you have a fever greater than 100.4 degrees? *

  6. Do you have any of the following symptoms: fever, cough, shortness of breath, sore throat or diarrhea?*

  7. Do you have any of the following symptoms?*

  8. Within the last 14 days, have you had contact with an individual diagnosed with COVID-19?*

  9. Have you traveled internationally in the last 14 days? *

  10. Do you have a face mask or face covering to allow entry into the building?*

  11. Temperature (Court to Process)

  12. Signature (Court to Process)

  13. _______________________

  14. _______________________

  15. Leave This Blank:

  16. This field is not part of the form submission.