Identity
Identify yourself by selecting ONE of the following

Health Questions
  1. Have you experienced symptoms of COVID-19 such as fever (temperature of 100°F or above) or chills, muscle or body aches, headache, cough, shortness of breath or difficulty breathing, sore throat, nasal congestion or runny nose, nausea or vomiting, diarrhea, or new loss of taste and/or smell in the past 10 days? Please note: if you are fully vaccinated and are having any symptoms of COVID-19 as described above, answer "yes", stay home, and contact your supervisor immediately.


  2. Have you tested positive for COVID-19 in the past 10 days?


  3. Have you had contact with anyone who has tested positive for COVID-19, or who have had symptoms of COVID-19, in the past 10 days?


Work Location
Where are you scheduled to work today (whether or not you are sick)?