Employee Health Screening Form
This Screening Tool is offered for informational purposes to help you check for COVID-19 symptoms as outlined by the Centers for Disease Control. The guidance you receive depends on the accuracy of the information you provide as well as current guidelines for identifying symptoms associated with COVID-19. Based on your self-reported answers, the tool will provide a response to be used by your employer. Please take the survey and provide the response to your employer according to your employer’s instructions.
This is not a substitute for professional medical advice, diagnosis, or treatment of disease or other conditions, including COVID-19. Always consult a medical professional for serious symptoms or emergencies.