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Covid-19 Health Declaration
How are you feeling today?
First Name
Last Name
Email
My body temperature is lower than 98.6 F/ 37.5 C
I am not experiencing the symptoms: fever, cough, sore throat
I have not been in close contact with a Covid-19 patient in the last 14 days
Initials
Date
I declare that the info I have provided is accurate and complete
Submit
Thanks for submitting!
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