Daily Health Screening

Employees are required to complete and submit the Health Screening Questionnaire before entering the office. This form will need to be completed and submitted each morning before you begin the workday.

COVID-19 Symptom Check

Name*
First Last
Date*
Month
Day
Year
1. Have you tested positive for COVID-19 or come into close contact (within 6 feet) with someone who has a confirmed COVID-19 diagnoses in the past 14 days?*
- Yes
- No
2. In the past 24 hours have you experienced the following: fever (100.0F or greater), chills, cough, shortness of breath or difficulty breathing, body aches, headache, new loss of taste or smell, sore throat?*
- Yes
- No