COVID-19 Screening Self Declaration Form
The safety of our employees, supplier partners, customers, families, and visitors remains the Catalyst group’s utmost priority. As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve and spread globally, we are following the current recommendations from the World Health Organization and Government of India. To prevent the spread of COVID-19 and reduce the potential risk of exposure to our workforce and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone around you. Thank you for your time.
Which of the statements below is applicable to you
I have undertaken an inter-state of inter-district travel
I reside in a containment zone
I have had close contact or cared for someone diagnosed with COVID-19 within the last 21 days
I/family member have experienced any cold or flu-like symptoms in the last 21 days
None of the above
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This form was created inside of Swasti Health Catalyst.