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Health & Wellness Questionnaire

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Please read and confirm the statement below by clickng "Submit". I do not A) have a fever now or have in the past 14-21 days, B) have not come in contact with any confirmed COVID-19 positive patients in the last 14 days, C) have a cough, D) am not experiencing shortness of breath or difficulty breathing.

A) I agree to the safety terms & conditions. B) I confirm I do not have any of the symptoms listed above.

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