FLS Health screen

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FLS Health screen

Pre-work health screening for COVID-19

Email *

I have a temperature above 100.3 Fahrenheit?

Yes

Have you experienced any of the following symptoms: One or more of the following: Cough, Shortness of breath/difficulty breathing, Loss of taste/smell, or Fever, Or Two or more of the following: Chills, Muscle aches, Headaches, Sore throat, Diarrhea, Nausea/vomiting, Congestion/Runny nose

Yes

Have you had close contact with anyone with a diagnosis of COVID-19? Close contact is being within approximately 6 feet of a COVID-19 case for 15 minutes within a 24 hour period; close contact can occur while caring for, living with, visiting, or sharing a health care waiting area or room with a COVID-19 case?

Yes

Have you been directed, or told by the health department, or your healthcare provider, to self-isolate or self-quarantine?

Yes

Have you traveled on mass transit system (Air, Bus, other)? Or have you been to an area/event where someone was suspected or actually was positive for Covid-19?

Yes

Send me a copy of my responses.

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