COVID-19 Screening Survey
Please answer the questions below to help determine eligibility.
- 1Are you experiencing any of the following symptoms? (Select all that apply)
- 2Within the past 2 weeks have you had close contact (less than 6 feet for over 10 minutes) with someone who has tested positive for Coronavirus/COVID-19 or have you been notified by the CDC?
- 3Is COVID-19 testing required for work clearance or a return to work status
- 4Pre Op Clearance for surgery?