Covid 19 | orchard-beauty

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Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: of fever, new continuous cough, loss of sense of smell or taste

I do not have any COVID -19 positive cases in my houshold

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

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