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COVID Staff Screen
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* Indicates required question
Staff First & Last Name:
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Your answer
I confirm I am absent of Fever & Symptoms
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Yes
No
Check Yes if: You confirm that I have NOT been 1) diagnosed with SARS-CoV-2 Infection in the prior 10 days, 2) exposed to others with SARS-CoV-2 during the prior 14 days. I am not undergoing evaluation for SARS-CoV-2 infection (pending Viral Test)
*
Yes
No
If the staff member is NOT cleared for entry, please answer why.
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