Statement of Symptoms and Quarantine
Statement of Symptoms and Quarantine

Statement of Symptoms and Quarantine.
Pursuant to the Governor of New Hampshire’s Emergency Order 27, all registered guests must
attest that they are exhibiting no symptoms of COVID-19. 
Symptoms Statement (Required by all guests.)

By signing this statement I, ___________________ (name) attest that no one in my party is
currently exhibiting any symptoms of COVID-19 such as:
1. Fever in the last 48 hours
2. Respiratory symptoms such as sore throat, cough, or shortness of breath
3. Flu-like symptoms such as muscle aches, chills, and severe fatigue
4. Changes in a person’s sense of taste or smell

Name: ________________________________

Signed: ________________________________ Date: ______________

Mask Mandate.
The Wentworth Hotel is continuing with a mask mandate, this means that the only times you are not required to wear a mask is in the privacy of your guest room and while dining in our restaurant and lounge. While dining though, we do ask that you wear your mask while interacting with my staff. 

 

Name: ________________________________

Signed: ________________________________ Date: ______________