COVID-19 Rochester High School

As part of our commitment to providing a safe and healthy workplace, this daily screening is required for entrance to the jobsite. Your answers will only be used to generate a pass/fail response, which may be shared with your employer. Thank you for providing honest answers. Together, we are doing our part to ensure a safe jobsite and minimize the spread of COVID-19.

By pressing “Submit”, you hereby certify that the below information is accurate to the best of your knowledge. If submit does NOT show, you are NOT allowed to enter the work site.

Enter your full name:*

Enter your company name:*

1) Within the past 14 day, have you been diagnosed with, or been in close contact with someone diagnosed with, COVID-19? (Close contact is 6 feet or less for more than 15 minutes over 24 hours)?

Employees who have tested positive for COVID-19 and since recovered do not need to quarantine or get tested again for up to 3 months after recovering if they do not develop symptoms again and may answer “No” to this question.

“Fully vaccinated persons” do not need to quarantine or get tested again if they do not develop symptoms again and may answer “No” to this question.

“Fully vaccinated persons” means persons for whom at least 2 weeks have passed after receiving the final dose of an FDA-approved or authorized COVID-19 vaccine.

Yes

If “Yes” to question 1, you cannot enter the site. Follow CDC guidelines and seek medical attention if necessary.

2) Are you currently waiting on COVID-19 test results?

Yes

If “Yes” to question 2, you cannot enter the site. Follow CDC guidelines and seek medical attention if necessary.

3) In the past 48 hours, have you had any new or unexpected symptoms that are not attributable to another condition: cough, fever, chills, sweating, difficulty breathing, muscle aches or body aches, vomiting or diarrhea, or new loss of taste or smell?

Yes

If “Yes” to question 3, you cannot enter the site. Follow CDC guidelines and seek medical attention if necessary.

COVID-19 Rochester High School

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