Health Declaration

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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

Thanks for submitting!

Hridayam, LLC.

(786) 473-4175 Miami, FL

Website designed by Carol Jamault

ABOUT
MASSAGE
- PACKAGES
COACHING
- CONSULT
- LEARN
APOTHECARY
BLOG
CONTACT
GIFT CARD

The statements made on this website have not been evaluated by the Food & Drug Administration. Our services and products are not intended to diagnose, cure, or prevent any disease. If a condition persists, please contact your physician or health care provider. The information provided by this website or this company is not a substitute for a face-to-face consultation with a health care provider, and should not be construed as individual medical advice.

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