Please fill in 48hrs before you are due to come and join us on retreat.Covid -19 Screening formHave you returned from another country or a Red List Country in the last 14 days?* Yes NoDo you have a persistent cough or temperature?* Yes NoDo you have any change or loss to your sense of smell or taste?* Yes NoHave you been in contact with anyone who has COVID-19 symptoms?* Yes NoHave you been asked to self-isolate?* Yes NoHave you received a letter from the NHS saying that you are at high risk, or consider yourself to be?* Yes NoDo you or have you worked in a front line role which may have brought you into contact with COVID -19?* Yes NoHave you had a Covid-19 Booster Vaccination* Yes NoI will inform The Body Retreat if I show any symptoms of Covid with in 14 days of leaving the Retreat.* I agree I don't agreeIf you have answered "Yes" to any of the above question then we will contact you to discuss the possibility of your joining us on retreat.Full NameFull AddressPhone NumberToday's DateNameThis field is for validation purposes and should be left unchanged.