Az Visitation Attestation

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AZ Visitation Attestation

Congregate Settings

Page 1

Please complete this form prior to visiting the facility.

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Description:AZ Visitation Attestation for Congregate Settings

The AZ Visitation Attestation form is designed for congregate settings to ensure the safety of residents and visitors during the COVID-19 pandemic. This form requires visitors to attest to their health status and potential exposure to the virus before entering the facility. By completing this form, visitors can help prevent the spread of COVID-19 and protect vulnerable populations. The form includes questions about symptoms, recent travel, and contact with individuals who have tested positive for the virus. It also includes instructions for visitors to follow while in the facility, such as wearing a mask and practicing social distancing.

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