Lutwina Boersma VISITATION ONLY Sign-up
(Covid-19 protocols monitored - Masks required)
Please review these screening questions and only sign up if you are able to answer no to all:
https://www.health.gov.on.ca/en/pro/programs/publichealth/coronavirus/docs/2019_screening_guidance.pdf

-Communicate with your group so you all arrive in a timely manner and together.
- We will call your cell phone to invite your group into the funeral home at your confirmed visiting time.
Email address *
Last Name *
First Name *
Number of people in your household/bubble that will be attending together at the same time slot (max 5) *
Cell phone number *
State your preferred 10 min time slot between 1-4 pm (this will be confirmed either by a phone call or an email) (eg. 2:10, 2:20, etc.) *
Submit
Never submit passwords through Google Forms.
This form was created inside of Wall-Custance Funeral Home and Chapel. Report Abuse