PLC Daily Health Screening
Please complete this form each day before arriving at PLC. If you answer "Yes" to any of the questions, please stay home. Thank you.
Name *
Do you have a temperature greater than 100°F? *
Did you take any medication to reduce a fever (e.g., ibuprofen, tylenol)? *
Do you have any symptoms of fever, cough, or shortness of breath? *
Are their members of your household who have any symptoms of fever, cough, or shortness of breath? *
Have you had close contact with anyone who has been diagnosed with COVID-19 in the past 14 days? *
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