Screening Location:
 Employee ID #
 Date of Birth YEAR:
 Last Name:

1. Have you had an exposure to a COVID-19 positive person in the past 14 days?
2. Have you travelled outside the United States of America in the past month?
3. Do you have a fever?
4. Do you have a new cough, sore throat, or shortness of breath?
5. Do you have a new onset of fatigue or muscle weakness?
6. Do you have a new loss of smell or taste?
7. Do you have a new vomiting or diarrhea?
8. Do you feel ill?

Note: Do not click submit until you are at screening location. You will be required to show your results to screener.