Occupational Health Employee Screening Tool

Have you had any signs or symptoms of a fever in the past 24 hours such as chills, sweats, felt "feverish" or had a temperature that is elevated for you/100.0F or greater?*
- Yes
- No
Do you have any of the following symptoms?*
- Cough
- Shortness of Breath or Chest Tightness
- Sore Throat
- Nasal Congestion/Runny Nose
- Myalgia (Body Aches)
- Loss of Taste and/or Smell
- Diarrhea
- Nausea
- Vomiting
- Fever/Chills/Sweats
- Yes
- No
Have you had any close contact in the last 14 days with someone with a diagnosis of COVID-19?*
- Yes
- No