***PLEASE NOTE THERE HAVE BEEN CHANGES TO THE SURVEY***
Please record your Banc email, today's date, and your work location, then respond to questions 4 through 15. If you answer "yes" to any of the questions below, you will be directed to a second set of questions. Please answer thoroughly. 

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* 1. Banc email, First.Last@bancofcal.com

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* 2. Today's Date

Date
Time

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* 3. Location

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* 4. Had a high temperature and/or felt feverish or chills?

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* 5. Developed a new or worsening cough or sore throat?

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* 6. Experienced shortness of breath or difficulty breathing?

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* 7. Experienced a new loss of taste or smell?

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* 8. Experienced out of the ordinary congestion or runny nose?

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* 9. Experienced unaccounted muscle pain or fatigue?

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* 10. Experienced an unusual or out of the ordinary headache?

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* 11. Experienced out of the ordinary digestive issues or diarrhea?

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* 12. Have you had contact or exposure to people or gatherings with COVID-19 in the last 14 days?

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* 13. Are you or anyone in your household or company you have been around pending test results because of symptoms of Covid-19?

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* 14. Are you currently subject to an isolation or quarantine order?

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* 15. Have you answered "yes" to any of the questions above? 

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