THSH Visitor Health Certification Form

If you answered yes to any of the above questions, do not go to the office. Contact Lisa Maline at (631)-404-0971.You are required to notify Lisa Maline at (631) 404-0971 immediately if your answers to the above questions change in the last 14 days, such as if you start to experience any symptoms of COVID-19. Symptoms of COVID-19 include, but are not limited to: cough, shortness of breath or difficulty breathing, fever, chills, muscle pain, sore throat, or new loss of taste or smell.
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