BV - COVID-19 Employee Self Assessment
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Current Temperature (optional)
Have you been within 6 feet of a person with a lab-confirmed case of COVID-19 for at least 5 minutes, or had direct contact with their mucus or saliva, in the past 14 days?
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In the last 24 hours have you had any of the following NEW symptoms?  Check all that apply.
Please confirm that you have sanitized your work area before leaving on the previous business day.
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