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PRINT NAME: DATE OF BIRTH: COVID-19 SILK-SCREENING I do not have any of these life-threatening symptoms. Pale, gray, or blue colored skin, lips, or nail beds, depending on skin tone Severe and constant
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Any individual who is required to undergo self-screening for COVID-19, based on their employment, travel, or participation in specific activities, may need the covid self-screening formdocx. This can include employees returning to work, travelers entering certain countries or establishments, students attending educational institutions, or individuals participating in events or gatherings where screening is mandated.
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The COVID self-screening form is a document used to determine if an individual is exhibiting symptoms related to COVID-19 or has been in contact with someone who has tested positive for the virus.
Individuals, including employees, students, and visitors, may be required to file the COVID self-screening form before entering certain facilities or workplaces.
To fill out the form, individuals must provide personal information and answer a series of questions regarding their health status, recent travel, exposure history, and COVID-19 symptoms.
The purpose of the COVID self-screening form is to identify individuals who may be at risk of carrying the virus, thereby preventing the spread of COVID-19 within a community or workplace.
Individuals must report their name, contact information, possible symptoms, recent travel history, and any known exposure to COVID-19.
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