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COVID-19 SCREENING FOR CPS PROGRAM
Please fill out the following health declaration form in order to participate in our activity. Submissions are only valid the day of your visit.
Are you/the person attending the CPS program presenting with a Fever?
Are you/the person attending the CPS Program experiencing a new or worsening cough?
Have you/the person attending the CPS Program have close contact with acute respiratory illness?
Do you/the person attending the CPS program have a confirmed case of Covid-19, or had close contact with a confirmed case of Covid-19?
I confirm that the information given in this form is true
Thanks for submitting!