COVID-19 Site Visit Request
Please complete this form to request a voluntary and informational site visit by the Larimer County Department of Health and Environment COVID-19 Response Team.
Name of Establishment or Business
Street Address Line 2
State / Province
Postal / Zip Code
Establishment or Business Contact Name
Site Visit-Preferred Date and Time (Please note: this helps our team better understand your preferred availability. This does not schedule a site visit. Our team will contact you to coordinate the final scheduled visit.)
Site Visit-Alternate Date and Time
Why is a site visit being requested?
Any questions or feedback for us before we visit your site?
Should be Empty: