Screening - The Dome

Hello! Under order of the Municipality of Anchorage, you’ll need to answer these questions and record your name and phone number before you can enter The Dome.

Have you been outside Alaska since May 15th, 2020?*

Yes
No

Have you been in contact with anybody with a suspected or confirmed case of COVID-19 since May 15th, 2020?*

Yes
No

Are you currently experiencing any of these symptoms? Cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, or sore throat?*

Yes
No

Have you had a fever in the last 72 hours?*

Yes
No

Sorry, but under Municipal Order EO-09, you are not allowed to enter The Dome at this time.

Name*

First Last

Phone*

Consent*

Yes, I agree.

The User fully understands and appreciates both the known and potential dangers of utilizing the facilities, services, and programs of The Dome and acknowledges that use thereof by the undersigned and/or participating children may, despite The Dome’s reasonable efforts to mitigate such dangers, result in the exposure to COVID-19.