Summerfield Schools Workplace Screening Survey
This Screening Survey is to be used by any Summerfield Schools employee PRIOR to entering a Summerfield Schools building to ensure the general health of the employee as it relates to the COVID-19.  The guidance you receive depends on the accuracy of the information you provide as well as current guidelines for identifying symptoms associated with COVID-19. Based on your self-reported answers, the tool will provide a response to be used by your employer. Please take the survey and provide the response to your supervisor prior to entering a Summerfield Schools building.

This is not a substitute for professional medical advice, diagnosis, or treatment of disease or other conditions, including COVID-19. Always consult a medical professional for serious symptoms or emergencies.
Sign in to Google to save your progress. Learn more
Enter your full name. *
How are you associated with Summerfield Schools *
If you are a Parent/Contractor/Vendor/Visitor, please list who you are here to see.
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Summerfield Schools.

Does this form look suspicious? Report