State of The Nation
WHO WE ARE
FACILITY REQUEST FORM
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Complete this form & we will contact you soon!
Have you had close contact within the last 14-days, with someone who is currently sick with suspected or confirmed COVID-19?
Have you had a fever in the last 14 days (Temperature at or above 99.9)?
Have you experienced any of these symptoms within the last 14 days? Please check all that apply.
Shortness of breath (not severe)
Repeated shaking with chills
New loss of taste or smell
Vomiting or diarrhea in the last 24 hours
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
Time is TBD