COVID-19 Health Screen

Daily COVID-19 Screening for Employees

To keep you and all our employees safe, we are following local health department recommendations and requiring that every employee be assessed for COVID-19 symptoms and risk factors each day before entering our facility.

The survey must be completed prior to your shift. Regardless of survey results, if you feel that you have symptoms related to COVID-19 please contact a healthcare professional.

The survey below should be completed on all days you are scheduled to work in our facilities.

Question Title

* 1. Name

Name

Question Title

* 2. Have you come into close contact (within 6 feet) with someone who has a laboratory-confirmed COVID – 19 diagnoses in the past 14 days?

Yes

Question Title

* 3. In the past 24 hours have you experienced the following: fever (100.0F or greater), chills, cough, shortness of breath or difficulty breathing, body aches, headache, new loss of taste or smell, sore throat?

Yes

If you answer yes to any of the questions above you may need COVID-19 testing. Do not proceed to the office and contact your immediate supervisor. Self-isolate and contact your primary care physician.