Get Covid-19 Screening Questionnaire 2021-2026

Completing the COVID-19 Screening Questionnaire is essential for ensuring a safe work environment. This guide provides clear instructions on how to fill out the questionnaire online, helping you navigate each section effectively.

Follow the steps to complete the questionnaire accurately.

1. Press the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Enter the date in the designated field to indicate when you are filling out the questionnaire.
3. Provide your full name in the specified section to confirm your identity.
4. Fill in your email address to ensure you can be contacted if necessary.
5. Review the list of symptoms that may indicate a COVID-19 infection. For each symptom listed, select 'Yes' or 'No' based on your health status over the past 14 days.
6. Indicate whether you or someone you live with has been diagnosed with COVID-19 in the past 30 days by selecting 'Yes' or 'No.'
7. Answer the question regarding any close contact with an individual diagnosed with COVID-19 in the past 14 days by choosing 'Yes' or 'No.' Remember that close contact is defined as being within 6 feet for more than 10 minutes.
8. In the signature field, sign your name electronically to certify the accuracy of your responses and acknowledge the importance of honesty in this screening process.
9. Once all sections are filled out, you can save your changes, download a copy of the completed form, print it for your records, or share it as required.

Complete the COVID-19 Screening Questionnaire online to help ensure a safe workplace for everyone.