HOME
COVID-19
WATCH
EVENTS
GIVE
JOIN
ABOUT
MINISTRIES
CONTACT
More
Complete this form & we will contact you soon!
*
First Name
*
Last Name
*
Email:
*
Phone Number:
Have you had close contact within the last 14-days, with someone who is currently sick with suspected or confirmed COVID-19?
Yes
No
Have you had a fever in the last 14 days (Temperature at or above 99.9)?
Yes
No
*
Have you experienced any of these symptoms within the last 14 days? Please check all that apply.
Shortness of breath (not severe)
Cough
Chills
Repeated shaking with chills
Muscle pain
Headache
Sore throat
New loss of taste or smell
Vomiting or diarrhea in the last 24 hours
None
Have you traveled outside of the state (to any area considered a hot spot) within the last 14 days?
Have you traveled outside of the country within the last 14 days?
*
*By checking this box, I acknowledge that 1) my attendance at JTOPNashville is voluntary & my choice 2) JTOPNashville & its counterparts are not liable if I develop any symptoms of COVID-19
I Acknowledge
I'M READY
Baptism
Time is TBD
JTOPNashville