HVWS Visitor Self Screening Checklist Form
HVWS is restricting all nonessential visitors/vendors/contractors from entering buildings on campus at this time. In addition, the following protocols must be met:
All visitors/vendors/contractors must answer health screening questions.
All visitors/vendors/contractors are required to wear face coverings.
Hand sanitizer must be used at all points of entry to buildings for visitors and vendors to use upon entering a building or any room within a building.
Site deliveries should include only minimal contact and cleaning protocols should be followed. Delivery personnel should practice physical distancing measures and wear a mask. If this is not possible, they stay in their vehicles.
Visitor COVID-19 Health Screening
In an effort to continue to provide a safe workplace, prevent the spread of COVID-19, and comply with the Connecticut requirements, all visitors must confirm they are not experiencing COVID-19 defined symptoms.
Please complete the following questions. If you answer “yes” to any of the questions, you are not permitted to be on campus.
First and Last Name
Organization or Company you represent, or, staff or faculty member you are assisting.
Date of visit
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