Daily COVID-19 Health Questionnaire

To keep you, our other employees and customers safe, we are following the guidelines, and recommendations of the New Jersey Department of Health and requiring that every employee be assessed for COVID-19 and other pandemic illness symptoms and risk factors each day before work.  The below questionnaire must be completed by each employee at the beginning of every work day.

* Your Name:

* Do you currently have a fever above 100.4?

* Have you had COVID-19 or any other pandemic illness within the last 14 days, or have you been tested for it within the last 14 days?

* Have you had any signs or symptoms of a fever in the past 24 hours such as chills, sweats, felt "feverish" or had a temperature that is elevated for you of 100.4 or greater?

* Do you have any of the following symptoms?

* Have you travelled internationally or outside of NJ in the last 14 days (excluding NY)?

* Within the last 14 days, have you been exposed to, or come in contact with, anyone you know: (A) who has COVID-19 or other pandemic illnesses, (B) who is/was being tested for COVID-19 or other pandemic illnesses, (C) who had symptoms consistent with COVID-19 or other pandemic illnesses, or (D) who was exposed to someone with COVID-19 or other pandemic illnesses?

* All information is certified to be truthful and accurate. Regardless of how you answer the questions provided in this survey, if you have symptoms consistent with COVID-19 or feel you may be developing those symptoms, you are excluded from work and should contact a healthcare professional.

SUBMIT DAILY COVID-19 HEALTH QUESTIONNAIRE

Thank you, your answers have been logged. If you answered YES to any of these questions, please contact Matt Green immediately.