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Abbey Group & Other Contractors Covid-19 Employee Health Survey
Abbey Group employees, and other contractors working for the SSD, are required to complete this health screening form each time you are going in to access your worksite, beginning September 3, 2020.

Remember, IF YOU HAVE A FEVER (temperature of 100.4 or higher), ANY SYMPTOMS OF COVID-19 INFECTION OR HAVE HAD RECENT CLOSE CONTACT WITH SOMEONE WHO HAS A CONFIRMED CASE, you are not permitted to go into work and should contact your supervisor immediately.

This form should be completed at home on the actual day of entry to your worksite.

For more detailed information about COVID-19 symptoms:

(Credit: thanks to WCSU for use of their form)
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Email *
Worksite(s) *
Your name *
Your phone number *
Do you have any of these symptoms: headache, Fever (100.4 or greater); chills, cough, shortness of breath or difficulty breathing; muscle pain or body aches; sore throat; fatigue; new loss of taste or smell; congestion or runny nose; nausea, vomiting or diarrhea? *
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