Pre-Cruise Questionnaire

Anticipated Start Date of Cruise: *

What is your age? *

Some underlying medical conditions INCREASE the risk of a person getting COVID-19. Do you have any of the following conditions?

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fgroups-at-higher-risk.html

Other underlying medical condition(s):

Some chronic medical conditions MIGHT put COVID-19 patients at higher risk. Do you have any of the following chronic medical conditions?

Other chronic medical condition(s)

Have you experienced any of these symptoms in the past 24 hours? *

Have you ever been diagnosed with COVID-19? *

Does your role on this cruise include SCUBA? *

Have you been medically cleared to SCUBA?

Have you TRAVELED to an area designated by the CDC as a Level II (or higher) area in the past 14 days? *

https://www.cdc.gov/coronavirus/2019-ncov/travelers/map-and-travel-notices.html

In the past 14 days, have you had close contact with someone who is diagnosed with COVID-19? *

A close contact is defined as a person who: provided care for the individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment OR who lived with or otherwise had close prolonged contact (within 6 feet) with the person while they were infectious OR had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment

How would you rate your overall satisfaction with how FIO is handling COVID-19?

First and last name: *

Email *

Phone

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