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Meadows COVID-19 Screening:
Please fill out and submit this form within the first 30 minutes of your shift each work day. This information goes directly to Sarah Johnson and is considered confidential.
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Your Name
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Your answer
In the past 24 hours, have you experienced a new cough (different from baseline), shortness of breath, muscle or body aches; diarrhea or vomiting; new loss of taste or smell, or had a fever ≥ 100.4°/ felt feverish (chills, sweating)?
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Yes
No
Are you currently under quarantine orders because you have been in close contact with a positive COVID-19 case?
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Yes
No
Are you currently under isolation orders due to a positive COVID-19 test result?
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Yes
No
Have you taken a COVID-19 Test in the last 72 hours and are waiting for your results?
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Yes
No
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