GiFT's daily screening for staff/volunteers
Please complete this form prior to or upon your arrival at GiFT.
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Your first and last name *
1. I have not been diagnosed with COVID-19 in the past 10 days. *
Required
I do not live with someone who has been diagnosed with COVID-19 in the past 10 days. *
Required
3. Within the past 10 days, I have not been in close physical contact (6 ft or closer for 15 min or longer) with: • anyone diagnosed with COVID-19 -OR- • anyone who has symptoms of COVID-19 *
Required
4. In the past 48 hours, I have not experienced (new onset or unexplained) any of the following symptoms: • fever/chills • sore throat • difficulty breathing • unexplained muscle aches • cough • fatigue • headache • loss of sense of smell/taste • nasal congestion not related to allergies • nausea • vomiting • diarrhea *
Required
Vaccination statement *
Required
By checking this box, I agree to comply with GiFT practices in masking, distancing, and other safety and health measures. I have reviewed GiFT's guidelines: https://www.givingisafamilytradition.org/covid-19 *
Required
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