Essential workforce Saliva testing

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Sublette County Public Health is excited to begin our COVID-19 testing surveillance plan for Sublette County. To gear up for the arrival of our testing supplies, we are asking that businesses or organizations deemed essential to complete this form.

What is the name of your organization *

Who is your organization's Point of Contact (POC) for this testing program. The POC will be asked to select which employees in your organization will be tested each time *

Point of Contact email address. *

How many total employees (please include ALL shifts) does your organization have? *

Please choose only ONE from the following: My organization is: *

Medical

School/ Day care

Government

Law Enforcement

Essential Business (Grocery store, Post Office, Senior Center, etc.)

Other:

Required

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