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Palo Alto Buddhist Temple
Self-Health Reporting Questionaire


Phone Number: 650 856 0123



Palo Alto Buddhist Temple 

2751 Louis Road
Palo Alto, CA 94303

To prevent the spread of COVID-19 and ensure the health safety of all attendees at any PABT functions and/or services involving Sensei Kodama, please complete the following ATTENDEE questionnaire.

This should be completed ON THE DAY OF the meeting/event/service attended.

You will need to show proof of completion of this form upon arrival.

Type of Meeting/Event/Service (Required)

Thanks for submitting!

Date of Meeting/Event/Service you are attending *
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