COVID-19 Compliance Verification Form

This Form has Moved - Please Click this link

DO NOT CONTINUE on this form. Use link above for updated form.

This form serves to verify that Grand County Businesses agree to follow the safety guidelines published in Colorado's Safer At Home Public Health Order and Grand County's Standing Public Health Order (April 27, 2020).

Once you submit this form, you will receive a CONFIRMATION SCREEN that includes links to referenced signage. DO NOT CLOSE THIS SCREEN UNTIL YOU HAVE PRINTED THE SIGNAGE. A copy of your responses will be saved by Grand County Public Health.

While this form is intended to flexibly accommodate businesses across industry and remain valid as Colorado's Safer at Home order allows additional business types to open throughout the coming weeks, businesses are responsible for ensuring that their opening timeline does not precede the dates referenced in Colorado's Safer At Home Public Health Order. A quick reference guide that lists opening dates for a number of industries is available below.

This form covers Phase 2 of the Grand County COVID-19 Mitigation and Suppression Plan, by Public Health Order dated April 27, 2020, unless specified as a Phase 3 Grand County COVID-19 Mitigation and Suppression Plan measure which we anticipate to closely mirror the governor’s "Protect your Neighbor" Phase.

The strictest guidance measures available shall be implemented and be enforced.

Please refer to the Colorado “Safer at Home” Public Health Order and Guidance Documents published by the State of Colorado on April 26, 2020. The links to those documents are located below. Please read the documents to review your specific industry's guidance below before completing the Compliance Verification Form. **Take note of dates of when you can open.

Questions regarding compliance verification email or call 970-725-3808.

State of Colorado "Safer At Home"

Industry-specific guidance (Colorado Department of Public Health & Environment "Public Health Order 20-28 Safer at Home")



Email address *
Grand County Dates of Reopening (working doc)
Owner Name (Or Manager) *
Owner (Or Manager) Phone Number *
Business Name *
Facility Address *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy