Form
Covid-19 Declaration
Are you experiencing any of the following symptoms?
Fever
Difficulty Breathing
New Onset Cough
I declare that I am NOT experiencing at least two of the following symptoms: Chills, Barking cough, making a squeaky or whistling noise when breathing, shortness of breath, sore throat, difficulty swallowing, hoarse voice, runny nose, stuffy or congested nose, lost sense of taste or smell, headache, digestive issues, fatigue
Check here to confirm
Should be Empty: