COVID QUESTIONNAIRE

Please complete this form no more than 24 hours before you are scheduled to arrive at ThunderShot Studios.
CONTACT INFORMATION
Your First Day On Set*
MM slash DD slash YYYY

(Click calendar icon)
Name*
First Last
Email*
Phone*
Do you have COVID-19 immunity because you are full vaccinated and/or you already had the virus?*
- YES
- NO

EXPOSURE RISK ASSESSMENT
In the past 14 days, have you had contact with, or cared for, anyone with confirmed or suspected COVID-19?*
- YES
- NO
In the past 14 days, have you been in any location with a widespread COVID-19 outbreak?*
- YES
- NO
If yes, list the area(s) by city, state, or region.*

PERSONAL HEALTH ASSESSMENT
Are you currently experiencing a fever over 100°F, difficulty breathing, sore throat or cough?*
- YES
- NO
In the past 14 days, have you had any two of these symptoms?*
- YES
- NO
- Cough
- Shortness of breath
- Difficulty breathing
- Fever
- Chills
- Muscle pain
- Sore throat
- Shaking with chills
- Headache
- New loss of taste or smell
Select all symptoms you have experienced.*

THUNDERSHOT COVID-19 SAFETY POLICY
As is true with all viruses and communicable diseases, each person is responsible for protecting themselves, and everyone around them, to the best of their ability. To mitigate the risk of exposure to COVID-19, ThunderShot has adopted the following policies:
- Access to the location is limited to crew, talent and necessary personnel.
- All equipment and cases must be wiped down and sanitized before arriving on set.
- Anyone who is sick is required to stay home.
- Everyone entering the building must have their temperature checked at the front desk by ThunderShot staff.
- Social distancing of no less than six feet is required whenever possible.
- A face mask that covers both nose and mouth is mandatory. Talent will wear masks, removing them as needed for make-up and when on set. Sanitizer is recommended when handling a mask.
- Everyone must self-monitor for signs of illness during the day and report any symptoms to personnel in charge of managing the shoot.
- Boom-only audio should be used whenever possible.
- Additional protective equipment (i.e., face shields, gloves, and gowns) is recommended for hair and make-up artists and sound technicians.
- Any equipment worn on the body (e.g., mics and transmitters, headsets, etc.) must be disinfected after use.
- Everyone should avoid handling equipment and personal items (e.g., cases, cameras, cards, computers, tape, lights, tools, and phones) that belong to others.
- All ThunderShot equipment must be wrapped to a designated place in the studio so that it can be sanitized before it is put away.
- Food must be provided as individual, pre-packaged snacks or contained meals.
- Everyone is required to clean up their personal trash and place reusable cups in the sink in the break room.
Consent*
I affirm that, to the best of my knowledge, I do not have COVID-19. I also agree to follow the coronavirus safety policies listed above when working at ThunderShot Studios.
Signature*

COVID QUESTIONNAIRE

ThunderShot Studios COVID-19 Agreement

Step 1 of 4

CONTACT INFORMATION

EXPOSURE RISK ASSESSMENT

PERSONAL HEALTH ASSESSMENT

THUNDERSHOT COVID-19 SAFETY POLICY

Fairfax, VA 22031 – USA

Kaboom@ThunderShotStudios.com

703-645-4044