IF YOU ANSWERED “YES” TO ANY OF THE SYMPTOMS LISTED ABOVE, DO NOT GO INTO WORK, AND IMMEDIATELY CONTACT JULIE SNOW-REGAN AND CC CAROLYN HANIF.
2. Have any of your family members or close contacts experienced any of the following symptoms: fever, cough, sore throat, respiratory illness, or difficulty breathing?
IMPORTANT: IF YOU ANSWERED “YES” TO ANY OF QUESTIONS 1 – 4 ABOVE, PLEASE CONTACT JULIE SNOW-REGAN AND CC CAROLYN HANIF AND AWAIT FURTHER INSTRUCTION AND/OR FOLLOW-UP INFORMATION REQUESTS.
I have truthfully answered all the questions on this questionnaire to the best of my knowledge. I further agree to check my temperature and symptoms daily to determine if my answers to this questionnaire need to be amended or supplemented.
I will be subjected to temperature and general wellness checks, and may be subjected to diagnostic testing, as a condition of employment and prior to commencing work duties at the site. I agree that if determined necessary in the sole judgement of onsite clinical personnel, based on clinical symptoms, medical history, travel history or any other objective or subjective indicator(s), I will submit to COVID-19 diagnostic testing.
I acknowledge that if my temperature exceeds 100.4 °F, or if I exhibit symptoms of COVID-19 as described above, or a diagnostic test returns positive for COVID-19, my access may be denied to the worksite and I will not be eligible to return until I receive a written release from a medical doctor verifying to the Company (in its sole discretion) I am not infected with COVID-19.