Client Pre-Visit Health Attestation
This should be completed by each client before entering a Moors & Cabot office for a scheduled meeting with their Financial Professional

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Email *
Your Full Name *
Phone Number (for contact tracing purposes only) *
Your Financial Professional *
Date of my Appointment
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Moors & Cabot Branch *
Have you had any of these symptoms within the past 14 days that are not caused by another condition: Fever (100.0 degrees or higher), Chills, Cough, Shortness of breath, Sore throat, Fatigue, Headache, Muscle/body aches, Runny nose/congestion, New loss of taste or smell, Nausea, Vomiting or Diarrhea? *
Have you been asked to self-isolate or quarantine by a doctor or a local public health official due to exposure, diagnosis or recent travel within the past 2 weeks? *
Do you have any reason to believe that you currently have COVID-19 or have been exposed to COVID-19 within the past two weeks? *
By checking this box, I acknowledge potential risks to my health which may be associated with entering a Moors & Cabot office and further agree to not hold Moors & Cabot liable for any health issues which may occur. *
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