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Enrolled Nurse Professional Association NSW
Lighting The Way
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Covid-19 Health Declaration
How are you feeling today?
First Name
Last Name
Email
Phone
My body temperature is lower than 37.5°C
I am not experiencing the symptoms: fever, cough, sore throat, Shortness of breath,
I haven’t been in close contact with Covid-19 in the last 14 days
I declare that the information I’ve provided is accurate & complete
I agree to the information provided above, to being shared with relavent authorities for the purpose of contact tracing
Date
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