iv vision productionHealth & Safety Form Name * Please enter your first and last name. First Name Last Name Email * Please enter your best contact email Phone * Please enter your best contact number Country (###) ### #### Date * Please enter today's date MM DD YYYY Emergency Contact Name * Please provide the first and last name of your best emergency First Name Last Name Emergency Contact Phone * Please provide the best contact number for your emergency contact (###) ### #### Dietary Restrictions | Allergies * Do you have any dietary restrictions/allergies? Yes No List Dietary Restrictions/Allergies If YES, please list your dietary restrictions and any other allergies below. COVID-19 Proof of Vaccination (1/4) * Are you vaccinated? Yes No Partially COVID-19 Proof of Vaccination (2/4) * Please check your status of vaccination. 1st Dose 2nd Dose Booster (Fully Vaxxed) COVID-19 Proof of Vaccination (3/4) * Will you be able to show proof of vaccination via email (to expotheseries@gmail.com) or on the first day of principal photography? If Yes, please choose one of the following. via Email First Day Check-In COVID-19 Proof of Vaccination (4/4) * If No, you agree to take a daily rapid PCR test at production check-in until principal photography is wrapped. Please choose from the following. Yes No Thank you for completing the IV Vision Health and Safety form!