Declaration Form | York Cottage Spa

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COVID-19 Track & Trace

How are you feeling today?

First Name

Last Name

Email

My body temperature is lower than 37.5°C

I am not experiencing symptoms: fever, cough, sore throat, loss of taste / smell

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!

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