Contact Name:
Company Name:
Your Title:
Phone Number:
Email Address:
Screening location city, state and zip code:
What will be the number of temperature screeners, shift times of the screeners and # of days per week?
How many employees require screening daily?
What ALL GREEN HEALTH services are you interested in? (You can select more than one) What ALL GREEN HEALTH services are you interested in? (You can select more than one) Mobile PCR Testing w/ Lab Analysis Lab Analysis Only ECO-Friendly Fogging & Surface Treatments IV Treatments N95 NIOSH Approved Masks Onsite temperature check by a healthcare pro Thermal cameras and self temp checks stands COVID-19 virus & antibody test kits
When are you planning to start? mm/dd/yyyy
Referral Code:
10 + 8 =
