COVID-19 Pre-Entry Screening for Critter Care

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Completion of this form is required for entry into the Critter Care Animal Hospital facility. Please note that entry is not guaranteed and is considered on a case by case basis. Ongoing case levels of COVID-19 in the County and State may require us to reduce access.

Email *

Your Name *

Your Critter's Name *

Appointment Date *

YYYY

Please answer if you (the human) have experienced any of the following recently: *

This list is the minimum necessary screening required by the CDPHE as part of Public Health Order 20-29

Yes

Fever

Cough

Shortness of Breath

Sore Throat

Muscle Aches

Chills

Exposure to someone with known or suspected COVID-19

Diagnosis with or quarantine due to suspicion of COVID-19

I have read and agree to comply with Critter Care Animal Hospital's restrictions regarding entry to the clinic. *

Yes

Required

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