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200 Old Lyman Rd.
South Hadley, MA 01075
p:
413-532-0374
e:
tgymnastic@aol.com
Covid-19 Health Declaration
How are you feeling today?
First Name
Last Name
Work Time
Email
I do not have a fever
Myself nor anyone in our household has any symptoms of Covid-19
I have not 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
Submit