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Thank you for doing your part in protecting our community against COVID-19 infection. Please complete the following questions to the best of your ability (your answers will be anonymous).
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Was there signage at the doors about required Mask wearing?
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Yes
No
I don't recall
Were ALL EMPLOYEES properly wearing masks?
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Yes
No
I don't recall
Was hand sanitizer readily available at the entrance?
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Yes
No
I don't recall
Were physical distancing measures in place (For example, floor markings, barriers, etc.)
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Yes
No
I don't recall
Date of Service
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Business Name and Location
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