Southeastern Daily Health Check
Your Branch: *
Your Name (First Last) *
Are you currently experiencing or have experienced a fever recently? (above 100.0 F) *
Are you experiencing a cough? *
Are you experiencing shortness of breath? *
Are you experiencing a sore throat? *
Are you experiencing diarrhea? *
Have you been in close contact with anyone that has been tested positive for COVID-19 in the past 14 days? *
Have you traveled outside your home state in the last 14 days? *
By checking the box below and submitting this form, I certify that these answers are accurate to the best of my knowledge and that I am the person named above in question #2. I understand that my failure to accurately report on my health or to mislead my health in this survey is a violation of company policy and may subject me to disciplinary action. I also understand that this information is being shared with Human Resources, the Leadership Team and my Manager. *
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