WCSD Employee Daily Health Self-Assessment
Each staff member must complete upon entering the building. To be completed daily via Google Survey OR hard copy.
Enter Today's Date *
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Last Name *
First Name *
Building *
If you work at multiple buildings, select the building in which you start your day.
Are you currently or have you in the last 24 hours experienced a new fever (100°F or higher) or a sense of having a fever? *
Are you currently or have you in the last 24 hours experienced a new cough that you cannot attribute to another health condition? *
Are you currently or have you in the last 24 hours experienced new shortness of breath that you cannot attribute to another health condition? *
Are you currently or have you in the last 24 hours experienced a new sore throat that you cannot attribute to another health condition? *
Are you currently or have you in the last 24 hours experienced new muscle aches that you cannot attribute to another health condition or to a specific activity (such as physical exercise)? *
Are you currently or have you in the last 24 hours come into contact with a person who has been diagnosed with COVID-19 or is experiencing symptoms of the illness? *
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