Transcription of CDC FACILITIES COVID-19 SCREENING
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CDC FACILITIES COVID-19 SCREENING
1 of 4CS326233-DSTOPTODAY S DATE: _____PLEASE READ EACHQUESTION CAREFULLY1. Regardless of your vaccination status, have you experienced any of the symptoms in the list below in the past 48 hours? IMPORTANT: ANSWER YES EVEN IF YOU BELIEVE THE SYMPTOM(S) IS BECAUSE OF SOME OTHER MEDICAL CONDITION (FOR EXAMPLE, ANSWER YES IF YOU HAVE A RUNNY NOSE BECAUSE OF ALLERGIES).2. Are you isolating or quarantining because you tested positive for COVID-19 or are worried that you may be sick with COVID-19 ?PLEASE CIRCLE THE ANSWER THAT APPLIESTO YOU AND FOLLOW THE INSTRUCTIONS BASED ON YOUR RESPONSECDC FACILITIES COVID-19 SCREENINGA ccessible version available at fever or chills cough shortness of breath or difficulty breathing fatigue muscle or body aches headache new loss of taste or smell sore throat congestion or runny nose nausea or vomiting diarrheaIf you have had any of these symptoms in the last 48 hours, DO NOT physically return to the work
Facilities APPROVED. CS326233-D 4 of 4 THE SCREENING YOU COMPLETED INDICATES THAT YOU MAY BE AT INCREASED RISK FOR COVID-19 RETURNING TO THE WORKPLACE IF YOU ARE NOT FEELING WELL, WE HOPE THAT YOU FEEL BETTER SOON! Before going to a healthcare facility, please call and let them know that you may have an …
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