🧴 Pre-Shift Screening Form Template
Required*
Employee Name
Required*
Employee ID
Required*
Did you or anyone you came in close contact with travelled internationally in the last 14 days?
Required*
Have you had any close contact with someone who has been diagnosed with COVID-19 or has experienced COVID-like symptoms within the past 14 days?
Have you experienced any of the following symptoms in the last 14 days?
Required*
Fever
Required*
Dry Cough
Required*
Tiredness
Required*
Aches and Pains
Required*
Sore Throat
Required*
Headache
Required*
Loss of Taste or Smell
Required*
Conjunctivitis
Required*