Personnel Health Screening Form: Effective 9/30/20

Any business or entity that is allowed to operate in San Francisco during the COVID-19 pandemic MUST screen Personnel with the questions below on a daily basis as part of its Social Distancing Protocol compliance and provide this information to Personnel. Go to www.sfcdcp.org/screen for more information or to view this form.

You can view the form at:

https://www.sfdph.org/dph/alerts/files/C19-07j-Personnel-Screening-Attachment-A-1.pdf

If you have any questions, please contact the office at 415-664-8331.

*Form based on SFDPH Order Dated 9/30/20
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