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Staff Covid-19 Health Check-In

Please fill out the form below for Daily temperature screening and to assist DOH officials in event of contact tracing.

Staff Covid-19 Health Check-In

Have you tested positive through a diagnostic test for COVID-19 in the past 14days?
Have you experienced any symptoms of COVID-19, including a temperature of greater than 100.00 degrees Fahrenheit in the past 14 days?
Have you traveled internationally or from a state with a widespread community transmission of COVID-19 per the New York Travel Advisory in the past 14 days?
Have you knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive through a diagnostic test for COVID-19 or who has or had symptoms of COVID-19?
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If you answered yes to any of these questions, you MUST stay at home and report via telephone for further Advisement. Call your healthcare provider for instructions, including getting tested for COVID-19. Only return to work if your COVID-19 test is negative, and/or you have a doctor's note from your healthcare provider or the local health department to return to work.

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