COVID-19 Employee Screening Questions COVID-19 Employee Screening Full Name * 1. Have you had COVID-19 symptoms (fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, the new loss of taste or smell, sore throat, congestion or runny rose, nausea or vomiting, diarrhea) in the past 14 days? * Yes No 2. Have you had a positive COVID-19 test in the past 14 days? * Yes No 3. Have you had close contact with a confirmed or suspected COVID-19 case in the past 14 days? * Yes No Result of temperature check: * Fever No Fever First Name and Last Initial of employee who checked your temperature: * reCAPTCHA Submit
