PLEASE NOTE: ProgressiveHealth reserves the right to terminate the observational experience of any person who
shows signs of communicable disease. If you are suffering from a cold, flu, fever, stomach virus or other indicator
of communicable illness, PLEASE CANCEL YOUR OBSERVATION AND RESCHEDULE.
ProgressiveHealth reserves the right to deny any application or to terminate the observational experience of
anyone who provides inaccurate application information or fails to observe ProgressiveHealth standards and policies.
I understand if I knowingly have an infectious illness, fever, cough I will refrain from visiting until at which
time my symptoms have improved and I am no longer infectious. I hereby certify the above information is true and
correct to the best of my knowledge.