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Employee Health Check
If you answer Yes to any of the following questions, please do not come to work. Instead, notify Jun or Frank right away.
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Name
*
First and last name
Your answer
Have you been confirmed positive for COVID-19?
*
Yes
No
Have you had any of the following symptoms since your last day at work or the last time you were here that you cannot attribute to another health condition: Fever of feeling feverish? Chills? A new cough? Shortness of breath? A new sore throat? New Muscle ache? New headache? New loss of smell or taste?
*
Yes
No
Have you been in close contact with any persons who have been confirmed positive for COVID-19?
*
Yes
No
Have you been in close contact with any persons who have traveled and are also exhibiting acute respiratory illness symptoms?
*
Yes
No
By checking this box, I certify that my answers are true and complete to the best of my knowledge.
*
I agree above disclaimer
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