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Heaney & Mill - Track & Trace
In order for us to comply with Government regulations, please fill out the following form in order to dine at Heaney & Mill.
First Name
Last Name
Email
Phone
I have not knowingly been in contact with anyone who has tested positive for COVID-19 in the last 14 days.
Are you experiencing any COVID-19 symptoms?
No
Yes
Date
Initials
I confirm that the information given in this form is true
Submit
Thanks for submitting and helping us keep everyone safe.
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