COVID 19 FORM | littlewonders

little WONDERS IS CURRENTLY OPEN for child care

Home
Activities
Rates
Contact
Calendar
COVID 19 FORM
COVID 19 POLICY
More

Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

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

Thanks for submitting!