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Covid-19 Health Declaration

HOW IS YOUR CHILD FEELING TODAY?

CHILD'S NAME

PARENT'S NAME

Email

My child's temperature is lower than 100.4F/ 37.5C

My child is not experiencing the symptoms: fever, cough, sore throat

My family has not been in close contact with a Covid-19 patient in the last 14 days

Initials

Date

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

Thanks for submitting!

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