Travel Survey

Submitting this form is entirely optional. No questions in this survey are required. You may submit as much or as little of the information requested in this form as you are comfortable sharing.

Recent Travel Information

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
If you spent time in the China, Iran, South Korea and most of Europe [CDC Level 3 European Country list] since March 1st:
  • Stay home for 14 days from the time you return from travel, monitor your health and practice social distancing. Social distancing means staying out of crowded places, avoiding group gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible.
  • If you get sick with fever (100.4°F/38°C or higher), cough, or have trouble breathing
  • Seek medical advice. Call ahead before you go to a doctor’s office or emergency room.
  • Tell your doctor about your recent travel and your symptoms.
  • Avoid contact with others.
  • Do not travel while sick.
  • Cover your mouth and nose with a tissue when coughing or sneezing.
  • Wash your hands often with soap and water for at least 20 seconds. If soap and water are not readily available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Soap and water should be used if hands are visibly dirty.

If you have returned from a country classified as Level 2 — which includes having returned to Bemidji from **any domestic travel** as the United States is now classified as Level 2 — since March 1,  please be diligent about self-monitoring with regard to your health and contact a doctor if you get sick.