Burlington PD Exam, Health & Wellness Survey
You must complete your survey before 5pm Friday, April 16th.. This is required for your participation in the written exam on the 17th.
Please fill in the last 4 digits of your Social Security Number:
Do you (or anyone in your household) currently have:
Yes: A fever, chills, or unexplained whole-body muscle aches?
Yes: A new or worsening cough, or difficulty breathing?
Yes: A headache, sore throat, runny nose, congestion, or fatigue?
Yes: Nausea, vomiting, or diarrhea?
Yes: Sustained loss of taste, smell, or appetite?
Yes: Any contact with suspected or confirmed cases of COVID-19 in the last 14 days?
Yes: A positive COVID-19 test result that you received in the last 14 days?
No: None of the above
Have you have you visited another state or another country in the last 14 days? (See
for more information)
Yes, I have visited
If you have answered "Yes" to any of the above questions, you may be able to sit for the exam if you have a Negative COVID Test result from a "molecular test" within 72 hours of your arrival. Otherwise: PLEASE DO NOT COME to the exam on Saturday, and contact Gretel Hartman (
) concerning your registration. Please leave an explanation and your comments below:
Police Exam Solutions, LLC. (PES) Terms and Conditions for this exam: You are responsible for your own health and wellbeing. PES will conduct the exam following the best practices and safety guidelines set forth by the CDC and Commonwealth of Massachusetts. We are not liable for any illness or accidents that may occur in association with this event. ____________________________________________________________________________ TYPE YOUR FULL NAME TO CONFIRM AND AGREE WITH THE ABOVE STATEMENT:
A copy of your responses will be emailed to the address you provided.
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