The Cat Connection Shelter

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Logging Shelter Attendance

By submitting this form, I attest to the following:

I do not have an elevated body temperature (fever), and I did not take any medication in the past 24 hours for the purpose of suppressing my body temperature.

Over the past 48 hours, I have not had any shortness of breath, new loss of taste or smell, sore throat, cough, muscle aches (myalgias), chills (with or without shaking), headache, new nasal congestion (not caused by allergies), or gastrointestinal concerns (e.g., abdominal pain, vomiting, diarrhea) that I cannot attribute to either a health condition other than COVID-19 or to simple exertion from a specific activity (such as physical exercise).

I have not had a positive COVID-19 diagnostic test result or been diagnosed with a “presumed” case of COVID-19 the past ten (10) days, nor am I awaiting test results for COVID-19.

I fully understand that animal scratches, bites, and other injuries may occur while working in the Cat Connection’s Shelter.

I fully understand that when working on the lower level of the Cat Connection’s Shelter that the ceilings are low with many obstacles.

I understand that wearing a well- fitted mask correctly in required at the shelter at all times.

Contact Information & Hours Worked


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(mm/dd/yyyy)

Please add duration using numbers, such as: 1.25 = an hour and 15 minutes; 1.5 = an hour and 30 minutes; 1.75 = an hour and 45 minutes