VISIONS Service Adventures: Pre-Program COVID Form
Which VISIONS program you are attending?
British Virgin Islands
Montana Blackfeet 1
Montana Blackfeet 2
Montana Blackfeet Middle School
Montana Farm and Ranch 1
Montana Farm and Ranch 2
Montana Farm and Ranch 3
Over the past ten days, have you, at minimum, adhered to your government, state or local requirements and recommendations regarding non-essential travel, social distancing, mask wearing, and group sizes, etc.?
Have you tested positive for Covid-19 within the last 90 days?
If you answered yes, please explain below.
(*NOTE- if you have tested positive in the last 90 days and are traveling to the D.R. or BVI, please call VISIONS office immediately at 406.551.4423)
Have you received a COVID-19 vaccination?
RECEIVED ONLY FIRST DOSE
Date of Initial Vaccination and Type:
If you have received a Covid-19 Vaccine, please upload a copy of your CDC card:
Have you received your Negative Pre-Program Covid-19 Test? (*
Note that this must be a Nasopharyngeal RT-PCR test taken within five days of traveling to the program).
Please upload negative test results here:
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