The purpose of this form is to help ensure a safe working environment for our employees and visitors. The information obtained here will only be used to assess the suitability of an individual to gain access to our facilities and/or to perform contact tracing in the event of a known COVID-19 infection event. This form is to be filled out by all visitors on the day of their visit PRIOR to their arrival to our offices. All visitors must fill out their own form. All fields are required.
Please use one of the methods below to complete the form before your planned visit to our office.
Follow this link and fill out the form:
RSNA - COVID-19 Visitor Questionnaire
Using a Smart Phone
Scan the QR code below and complete the form.
Using paper form
Click the form below to download the PDF formatted form, print it, complete it, and bring it with you on your visit.