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Covid-19 Health Declaration
How are you feeling today?
First Name
Last Name
Email
Date
My body temperature is lower than 98.6°F/ 37.5°C
I am not experiencing the symptoms: fever, cough, sore throat
I haven’t been in close contact with a Covid-19 patient in the last 14 days
I haven’t been outside of the USA or been in an airport in the last 14 days
I haven’t attended any events or gatherings with more than 5 people in the last 14 days
I haven’t been on a cruise ship in the last 14 days
I haven’t been in close contact with asnyone who has traveled domestically or internationally in the last 14 days
I haven't tested positive for COVID-19 in the last 21 days
Your Signature
Clear
I declare that the info I’ve provided is accurate & complete
Submit
Thanks for submitting!
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