Employee Daily Self-check Form
To be completed each day before coming into buildings
Your Email Address
Your Title or Department
Administration or School Principal
Business Office Staff
Cafeteria Worker or Head Cook
Custodian or Maintenance
Teacher or Secretary -- BUFFALO ELEMENTARY SCHOOL (BES)
Teacher or Secretary -- SOUTH BUFFALO ELEMENTARY SCHOOL (SBES)
Teacher or Secretary -- MIDDLE SCHOOL (FAMS)
Teacher, Assistant Principal, or Secretary -- HIGH SCHOOL (FAHS)
People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with one or more of the symptoms on the list below may have COVID-19.
● Temperature of 100.4° F or above
● Muscle aches
● Loss of smell or taste
● Sore throat
● Shortness of breath
● Nausea or vomiting, diarrhea, or loss of appetite
Are you currently experiencing one or more of the symptoms listed above?
Have you or anyone you have been in close contact with been diagnosed with COVID-19, or been placed in quarantine for possible contact with COVID-19?
Have you been asked to self-isolate or quarantine by a medical professional or a local public health official?
If you replied YES to any of the three questions above, STAY HOME and follow the steps below. DO NOT attempt to go into work.
► Step 1: Call your supervisor to report off/enter an absence in Frontline
► Step 2: Self-isolate at home and contact your primary care physician’s office for direction. That direction, including return to work note/script, should be shared with your direct supervisor before returning.
If you start feeling sick during your shift, immediately remove yourself from the premises, and follow Steps 1 and 2 above.
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