COVID Health Declaration | Northway Pharmacy Homecare

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Covid-19 Health Declaration

How are you feeling today?

First Name

Last Name

Email

My body temperature is lower than 98.6°F/ 37.5°C

I am not experiencing the symptoms: fever, cough, sore throat

I haven’t been in close contact with a Covid-19 patient in the last 14 days

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

Northway Pharmacy Homecare

At Northway Pharmacy Homecare, we stand by the belief that quality pharmacy care means more than just simply dispensing prescriptions. Quality care to us means that you get the prescriptions and medications that you need, along with the personal care and attention that you deserve.