COVID-19 Screening: Patrons

New York State requires us to maintain a record of this form for a minimum period of 28 days and make such data available to State and local health authorities upon request. WHBPAC will never sell your data, nor allow any person to view the information you give us who does not absolutely have to see it. The information you provide us will be kept private to the greatest extent possible.

This form must be filled out for each member of your party.