Coronavirus Disease (COVID-19)Workplace Health Screening for Hillsdale County ISD Staff
Please complete this form prior to entrance into an HCISD building. This form must be completed each day you are planning to be in an HCISD building. Please complete that day DO NOT complete the night before.
Email *
Date you are actually in the building *
MM
/
DD
/
YYYY
Time you are accessing the building *
Time
:
Current Temperature *
Are you currently experiencing any of the following symptoms: Please check all appropriate boxes *
Required
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