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info@newvitality.com.au

Health Declaration: Covid-19

How are you feeling today?

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Last Name

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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

Initials

Date

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

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Write a Review

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Room for Improvement

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Would you recommend us to your friends?

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Anything else you would like to add?

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