Within the last 10 days have you been diagnosed with COVID-19 or had a test confirming you have the virus?
Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19?
* You can edit more sensitive to questions to meet your business needs and still comply with state and local mandates.
* You can also include travel related questions to handle special cases such as for out of state travel or recent cruise-line trips. Just contact us for more information at firstname.lastname@example.org
Have you had any one or more of these symptoms today or within the past 24 hours, which is new or not explained by a pre-existing condition?