Get Coronavirus (covid19) Screening Form

Filling out the Coronavirus (COVID19) Screening Form online is a crucial step in ensuring your health and safety, as well as that of the community. This guide provides clear, step-by-step instructions to make the process simple and straightforward.

Follow the steps to complete the screening form effectively.

1. Click ‘Get Form’ button to access the screening form and open it in your preferred online editor.
2. Begin by filling out the 'Date' field to indicate when you are completing the form. This is important for tracking your health status over time.
3. Proceed to the 'Subjective' section which includes the Coronavirus Medical Screening Questionnaire. Answer each question honestly by selecting 'Yes' or 'No' for the symptoms listed, such as fever, cough, and difficulty breathing.
4. For question 2, provide details regarding recent travel and contact with individuals who have tested positive for coronavirus. Include specific locations if applicable.
5. Next, evaluate if you have any current medical conditions that may lower your ability to fight off infections. If the answer is 'Yes', please provide an explanation in the designated field.
6. After filling out the subjective section, move on to the 'Provider Comments' area, where additional remarks may be made if necessary.
7. Complete the section regarding your duty status and risk category by selecting the appropriate risk level according to CDC guidelines.
8. Under 'Recommend Actions', select any required actions such as restricting travel or self-monitoring. Indicate the duration of isolation or quarantine if applicable.
9. Finally, ensure you complete the screener's signature and stamp area along with your name and DOD ID number.
10. Once you have filled out all required sections, be sure to save your changes. You can then download, print, or share the completed form if needed.

Complete your Coronavirus (COVID19) Screening Form online today to stay informed and proactive about your health.