COVID-19
Please complete if you have tested positive for COVID-19, please do not come into the office. You can also call us at 480-982-4811 or email the General Manager at roadhavengm@gmail.com . You will remain anonymous; no person’s name shall be released.
Name
*
First Name
Last Name
Phone Number
*
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Area Code
Phone Number
Email
*
example@example.com
Park Address
*
If you have tested positive, you must remain in your home at all times. If you must leave your home for any reason wear a mask.
If you do need someone to pick up groceries or medication, call the front office and we can get someone to do this for you. You can also order groceries online for delivery from Frys, Safeway, and Bashas.
Once you have been tested negative, let the office know so that we can record this on our records.
Date you first starting feeling ill (estimated)
*
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Month
-
Day
Year
Date
Date tested for COVID-19
*
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Month
-
Day
Year
Date
Date you'll be retested for COVID-19 (estimated)
*
Submit
Should be Empty: