HS COVID-19 Sign Off
** This form must be completed daily - before you report to work **

COVID-19 symptoms include:
Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose

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Email *
First Name *
Last Name *
I have read and understand the list of symptoms associated with COVID-19 and hereby certify: *
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