STEM Academy - Employee COVID-19 Screening Questionnaire
The safety of our employees is our overriding priority. As the coronavirus (COVID-19) pandemic continues, we are monitoring the situation closely and following the guidance from the Centers for Disease Control and Prevention (CDC) and local health authorities. In order to prevent the spread of the coronavirus and reduce the potential risk of exposure to our workforce, we are asking everyone to complete and submit this questionnaire prior to entering the worksite.
Please read each question carefully and respond to each of the following questions truthfully and to the best of your ability. Your participation is important to help us to take precautionary measures to protect you and our other employees.
Please note that providing inaccurate information about your vaccination status may be grounds for discipline.
Note: The information collected on this form will be maintained as confidential.