Employee COVID-19 Self Screening Questionnaire

Your answer MUST be “NO” to all the questions in this questionnaire in order to enter our site.

If your answer is “YES” to any of the questions, please DO NOT enter the site, and you must immediately contact your health care professional, and notify your supervisor.

In the last 24 hours, have you had any of the following symptoms?

Cough, shortness of breath or difficulty breathing, fever, chills, muscle pains, headache, sore throat, new loss of taste or smell?

In the last 14 days, have you been in contact with someone who was diagnosed with COVID-19, or had COVID-19 symptoms? Make sure you click on SEND after your confirmation.

Employee COVID-19 Self Screening Questionnaire

Employee COVID-19 Self Screening Questionnaire

Your answer MUST be “NO” to all the questions in this questionnaire in order to enter our site.

My answer is No to all of the COVID-19 screening questions noted on this online form.