ISG Employee Covid-19 Questionnaire
To be completed daily upon arrival at work. This process will be updated or eliminated as the CDC and the Georgia State Health Department’s information on COVID-19 continues to change. Your health and well-being are of the upmost importance and we are taking measures to keep the gym a safe environment for employees as well as the individuals under our charge and the public.Therefore, employees will be screened and part of our screening process will include taking temperatures and asking the following questions:
Date *
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Employee Name *
Have you had contact with a person known to be infected, potentially infected, or exposed to someone infected with COVID-19 within the previous 14 days? *
Have you or someone you’ve been in contact with flown domestically or internationally in the last 14 days? *
Have you or someone you've been in contact with traveled to an area the CDC has deemed high risk in the last 14 days? (Florida, Arizona, California, New York or New Jersey)
Clear selection
Have you or someone you’ve been in contact with attended a gathering where proper social distancing protocol was not followed in the past 14 days? *
Have you had a fever, cough, shortness of breath, difficulty breathing, chills, muscle pain, sore throat, or new loss of taste or smell that cannot be attributed to another health condition in the past 2-14 days? *
Are you feeling unwell today? *
Do you have anyone in your home/have you interacted with anyone that is at a higher risk for contraction? (nurses, essential workers, etc.) *
Notes/Comments
If you have answered “yes” to any of the above questions, we may ask you to stay away from the gym for up to 14 days or until cleared by a medical doctor in coordination with the Georgia Department of Health (404) 657-2700.
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