Skip to content
HAC Runs Only On Your Donations. Please Donate Generously. Thank you! DONATE NOW

COVID-19 Declaration Form

    If the answer is “yes” to any of the following questions, access to the facility will be denied.
    Have you had close contact ( less than 6 feet) with or cared for someone diagnosed with COVID-19 within the last 14 days? YesNo

    Have you been in close contact with anyone who has exhibited cold or flu-like symptoms within the last 14 days? YesNo

    Have you experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough, sore throat, respiratory illness, difficulty breathing)? YesNo

    Back To Top
    Optimized by Optimole