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213-489-4182
Covid-19 Health Declaration
First Name
Last Name
Email
Phone
My body temperature is lower than 98.6°F/ 37.5°C
I am not experiencing the symptoms: fever, cough, sore throat
I haven’t been in close contact with a Covid-19 patient in the last 14 days
I agree to the terms & conditions.
View terms & conditions here
I agree to the terms & conditions outlined in COVID waiver.
View COVID waiver
Your Signature
Clear
Date
I declare that the info I’ve provided is accurate & complete
Submit
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