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APPENDIX B HEALTH SCREENING FORM FOR CONTRACTED WORKERS/VISITORS/VISITING STUDENTS Name: Date of Birth: / / SSN: Start Date: / / End Date: / / Sponsor*: Sponsors email: *The sponsor is the contact.

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Screenings are medical tests that doctors use to check for diseases and health conditions before there are any signs or symptoms. Screenings help find problems early on, when they may be easier to treat. Getting recommended screenings is one of the most important things you can do for your health.

For most adults, depending on age, doctors will recommend a screening schedule that includes regular physical exams, body mass index (BMI), skin checks, cholesterol and blood pressure screening, eye exams, immunizations and screening for sexually transmitted diseases.

Is their temperature greater than or equal to 100.0 degrees Fahrenheit? Have you had any known close contact with a person confirmed or suspected to have COVID-19 in the past 14 days? Have you traveled within a state with significant community spread of COVID-19 for long than 24 hours within the past 14 days?

Do you have any new or worsening symptoms not caused by an underlying health care condition: Fever of 100.4 or greater or chills? Cough? Shortness of breath or difficulty breathing?

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232