COVID-19 SCREENING TOOL

Use this tool to screen Employees, Clients and/or Visitors for symptoms of COVID-19.

Personal Info

 

Symptoms

 

Risk Factors

  • If you have answered "Yes" to any of the questions above, you will be asked to leave the building.

    *Employees : Please Contact Your Supervisor and Your Human Resources Representative.

    *Visitors : Please Call To Discuss When You Can Return To This Facility.

 

Verification