Employee Health Self-Screening & Checklist
Employees MUST self-screen for COVID-19 symptoms DAILY before they come to work. If you have any of the below symptoms you should not come to work that day and contact your administrator.
CHECKLIST UPDATED September 10, 2020
Have you have recently had any contact with anyone that is/has tested positive for COVID-19?
Indicate "Yes" if you are experiencing any of these symptoms that are not normal for you.
By coming to work, you are attesting that you confidently answered “NO” to ALL of the above questions and have a very low risk of carrying or spreading COVID-19. If you answered “YES” to ANY of the above questions, please contact your direct supervisor immediately and contact Colleen Corrigan at email@example.com or 512-570-0113.
Never submit passwords through Google Forms.
This form was created inside of Leanderisd.org.