COVID-19 Daily Health Screening

Please complete and submit the form below prior to entering facility each day.

NOTE: If a visitor has traveled to any state on the travel advisory list as specified on the website, we are asking you to stay away for a period of 14 days. After that time you may fill out the form again and enter our facility.
If you are an adult filling out this form for a minor, what is your relation to the child: parent, guardian, grandparent etc. If an adult filling the form out for self, simply place your full name.