top of page
The Upper Cumberland's Best Reviewed Cleaners!
Get A Free Estimate (931) 683-9858
Home
Cleaning Services
Services
Trash Valet
Message Us
More
Use tab to navigate through the menu items.
Covid-19 Health Declaration
How are you feeling today?
Full Name
Current Body Temperature
Have you been diagnosed with COVID-19 in the last 10 days?
*
YES
NO
Are you currently experiencing any COVID-19 symptoms including: cough, sore throat, fever, shortness of breath, loss of taste or smell, shortness of breath?
*
YES
NO
Have you been in close contact with anyone diagnosed with COVID-19 in the last 14 days?
*
YES
NO
I hereby certify that the above information is accurate to the best of my knowledge
Initials
Date
Submit
bottom of page
