Health Screening – ShapeShifter Lab

Covid-19 Health Screening Form:

Performing Artists, Event Production and Staff Members

Please promptly fill out the form below and submit it to us prior to arriving at ShapeShifter Lab. We reserve the right to turn down entry if no such form has been submitted. Thank you for your cooperation and let’s get through this difficult time together. It is a New York State requirement. Please also read the guidelines below.

Full Name

What is your role in this event?

Expected Date to be on Site

Expected Arrival Time

Expected Departure Time

1. Have you experienced a fever of 100.4 degrees F or greater, a new cough, new loss of taste or smell or shortness of breath within the past 10 days?

No - Go to the next question Yes - No further screening is needed. You may not participate in this event

2. In the past 10 days, have you gotten a positive result from a COVID-19 test that tested saliva or used a nose or throat swab? (not a blood test)

No - Go to the next question Yes - No further screening is needed. You may not participate in this event

3. To the best of your knowledge, in the past 14 days, have you been in close contact (within 6 feet for at least 10 minutes) with anyone while they had COVID-19?

No - You may proceed to carrying out work in the space Yes - You may not participate in this event

I have provided accurate information and have read the mandatory guidelines below.

Mandatory guidelines when you're inside ShapeShifter Lab: MUST READ!!!

We are currently at NYC operating under SMALL AND MEDIUM SCALE PERFORMING ARTS & ENTERTAINMENT re-opening guidelines.

You are required to wear a face mask at all times.
Upon entry, we will carry out screening measures such as taking your temperature and asking you to use hand sanitizers
Do not share food with others.
Bring your own water and beverages and no alcoholic beverages and NO eating inside the premises.
We ask you to take away your own trash and not leave it at the venue
You are required to keep social distancing at all times (min. 6 feet circumference around yourself)
Performers may temporarily remove their facecovering during performances/rehearsals, or when it interferes with a core activity, such as hair, makeup, or wardrobe. Performers must don face coverings following these activities.
No guests, friends, or relatives allowed unless pre-notified with approval.

We will refuse entry or ask you to leave the space if such measures are not strictly followed. After all, we want you to stay healthy and safe. The City, Fire Department, State Liquor License Authority are doing random inspections. Thank you for your cooperation.

Last update: May 1, 2021

Covid-19 Health Screening Form:

Mandatory guidelines when you're inside ShapeShifter Lab: MUST READ!!!

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