Please review and self-answer the following six (6) questions daily prior to going into the office.  If you answer "yes" to any question below, you MUST notify your supervisor and Human Resources immediately, quarantine and/or leave the workplace immediately.  You are not allowed to return to work until 72 hours after you are free from a fever or signs of a fever without the use of fever reducing medication.

Question Title

* 1. What is your name?

Question Title

* 2. When do you plan on working in the office today?

Question Title

* 3. In the last 10 days, have you, or anyone you have been in close contact with, been in contact with a person that has tested positive for COVID-19?

Question Title

* 4. Have you been medically directed to self-quarantine due to possible exposure to COVID-19?

Question Title

* 5. Are you having trouble breathing or had flu-like symptoms within the past 48 hours, including:  fever, cough, or shortness of breath?

T