Covid Info | Rize CoWorking

hello@rizemaine.com

(207) 814-7237

Follow us on Facebook!

Home
Member Info
Request Tour
About
Membership Options
- Membership Application
- Day Pass
Upcoming Events
More

Use tab to navigate through the menu items.

COVID-19 Vaccine Attestation

This form is provided so that members and guests of CoVort can attest to having received the COVID-19 Vaccination at least two weeks ago so they can move about the space without a mask.

First Name

Last Name

Email

By typing my name below, I certify that I have been fully vaccinated against COVID-19. Full vaccination means it has been two weeks since receiving both doses of either the Pfizer or Moderna vaccine, or after the single dose of the Johnson & Johnson vaccine.

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting. Thank you! Enjoy your mask free working!

hello@rizemaine.com | (207) 814-7327 | 735 Main Street, Bangor, ME 04401

©2022 by Briggs Solutions for Business