Palo Alto Buddhist Temple
Self-Health Reporting Questionaire

Email: office@pabt.org

Phone Number: 650 856 0123

 

Address: 

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 *