SUHSD BVH Employee Self Screening Form
Before coming to campus, please self-assess and DO NOT come to campus if you or
someone you have come in contact with has tested positive for COVID-19, is awaiting
results on a COVID-19 test, or if you are experiencing any of these symptoms:
a. Fever or chills
b. Cough
c. Shortness of breath or difficulty breathing
d. Fatigue
e. Muscle or body aches
f. Headache
g. New loss of taste or smell
h. Sore throat
i. Congestion or runny nose
j. Nausea or vomiting
k. Diarrhea
While on campus, please follow all safety measures below:
1. Follow social distancing guideline of 6ft apart.
2. Wear a face mask.
3. Regularly wash hands during the day.
4. Face to face contact with other people on campus must be less than 10 minutes.
* Required
Last Name
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First Name
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Your answer
BVHS Department
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Academic Support
Admin
CTE
Counseling Center
Campus Assistant & Custodial Team
English
Library
Math
Nutrition Services
Special Education
Science
Social Science
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