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Self-Declaration by Visitor
In an effort to reduce the risk of COVID-19 exposure to the Canterbury Community all visitors must complete the following screening questions:
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* Indicates required question
Email
*
Your email
Today's date:
*
MM
/
DD
/
YYYY
Visitors' names:
*
Your answer
Visitor's phone number:
*
Your answer
Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?
*
Choose
YES
NO
Have you experienced any cold or flu-like symptoms in the last 14 days (fever, cough, shortness of breath or other respiratory problem)?
*
Choose
YES
NO
Submit
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