COVID-19 Health Screening Declaration

Covid-19 Health Screening Declaration

All Visitors and Contractors must complete
The the last 14 days, have you had the following?
Have you had contact with someone that has a confirmed case of COVID-19?
Have you traveled outside of your home country as identified by the CDC/WHO (where COVID-19 exists) during the past 14 calendar days?
MM slash DD slash YYYY
Time
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By clicking this box, I confirm that the above information given is correct. I also understand that I must report any changes in my health status to supervision upon or before arrival.(Required)
This field is for validation purposes and should be left unchanged.
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