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COVID-19 Employee and Visitor Health Questionnaire

COVID-19 Employee and Visitor Health

*Upon arrival, all employees are to check in at the kiosk center in the main entrance of the building.*

1) Have you experienced COVID-19 symptoms in the last 14 days? (Fever, cough, shortness of breath or difficulty breathing, sore throat, new loss of taste or smell, congestion or runny nose, chills, head or muscle aches, nausea or vomiting, diarrhea): *
2) Are you currently experiencing any COVID-19 symptoms? (Fever, cough, shortness of breath or difficulty breathing, sore throat, new loss of taste or smell, congestion or runny nose, chills, head or muscle aches, nausea or vomiting, diarrhea): *
3) Have you tested positive for COVID-19 in the last 14 days? *
4) Have you had close contact with a confirmed or suspected COVID-19 case in the past 14 days? *
5) Have you traveled outside the U.S. in the last 10 days? *
**If you answered Yes to any of the above questions, you are not permitted to be in the office. Employees: Contact your manager/supervisor and the appointed COVID-19 representative for your office.

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