Employee Health Screening

Instructions

ALL employees and volunteers working with Guests must be asked the following below. This record will be kept for 14 days from completion of this form and this form is available upon request from the Public Health Department.
If YES to any, restrict them from entering the building and send person home.* If NO to all, proceed to remaining questions
If YES , restrict them from entering the building and send the person home. If NO, proceed to question #3B.
If YES , contact your supervisor immediately** If NO, proceed to #4
*The person being sent home, must inform their supervisor and Human Resources that they were sent home and is responsible for following-up with their primary care physician if needed. **Supervisors review COVID-19 policy for employees who have symptoms