South Bronx United COVID-19 Affirmation Form: 192 E 151st Street

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Please complete this within 12 hours of arrival.
Complete esto dentro de las 12 horas posteriores a su llegada.

If you answer Yes to any of the following questions, do NOT come to the building.
Si su respuesta es Sí a cualquiera de las siguientes preguntas, NO asista al oficina.

Si es un voluntario de la SBU o un visitante habitual y ha dado positivo en la prueba de COVID-19, please notify us at (718) 404-9281 or info@southbronxunited.org.
Si ha dado positivo en la prueba de COVID-19, notifíquenos al (718) 404-9281 o info@southbronxunited.org.

After completing this form, a receipt will be emailed to you. You will need this receipt to enter the building.

Email *

First Name / el nombre primero *

Last Name / el apellido *

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