COVID Test Contact Info (Required)
Hello Everyone...

Please fully READ the below information as it will help you successfully complete your form...

This form must be completed by everyone a minimum of 24 hours BEFORE attending your first "COVID Test" with our production.

!!! You only need to fill out this form ONCE !!!
No matter how many times you go for a COVID Test during this project.

If you have Filled out this Form already, then you can ignore it.

Your info will be available to the COVID Testers and the Nurse in advance, which means no more filling out forms every time you go for a COVID Test!

If you have already filled out this form or provided your information in person AND attended a COVID Test with our production, then you DO NOT NEED to fill this out again.
.
PARENTS:  Please submit one for yourself if you are accompanying your child AND one for each child you have in the project (Use your own Phone and email if your child is under 18yrs old )

The "Email" you give in this form - should be the one you "check" regularly.....  
Same goes for the Contact Phone Number please.

Thank you for your patience and cooperation with our “COVID” procedures.
We're doing our best to help keep everyone safe and healthy!

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Email *
Legal First Name *
Legal Middle Name(s)
Legal Last Name *
Name you go By
The Name you gave us when Registering for the Project - ONLY if different from your Legal Name
Best Contact Phone Number *
Parents of Younger Children - use your phone #
Date Of Birth *
MM
/
DD
/
YYYY
MB Health PHIN *
 The 9 Digit number on your MB Health Card
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