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Covid-19 Health Declaration
How are you feeling today?
First Name
Last Name
Email
I am NOT experiencing the symptoms: Fever or chills Cough ,Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea, and or I haven’t been in close contact with a positive Covid-19 person in the last 14 days
I am experiencing one or more of the following symptoms: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea, and or I have been in close contact with a positive Covid-19 person in the last 14 days. I understand I will not report to work, I will my manager and healthcare provider for further instructions.
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I declare that the info I’ve provided is accurate & complete
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