Covid-19 Health Declaration | BerrylandsPilates

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Covid-19 Risk Assessment Questions

First Name

Last Name

Email

My body temperture is normal

I am not experieriencing the symptoms:fewer, cough,sore throught, change if taste or smell

I haven't been in close contact with a Covid-19 patient in the last 10 days

Initials

Date

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

Thanks for submitting!

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