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COVID-19 Screening Form COVID-19 SCREENING FORM for STUDENTS Please complete this form to assess your potential exposure to or diagnosis of COVID-19 or other illnesses. If you answered Yes to any
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01
Obtain the covid-19 screening form from your employer or healthcare provider.
02
Fill out your personal information including name, contact information, and date of birth.
03
Answer all the questions accurately related to your symptoms, recent travel history, and possible exposure to covid-19.
04
Sign and date the form to certify that the information provided is true and accurate.
05
Submit the completed form to the designated recipient as instructed.

Who needs covid-19 screening form for?

01
Anyone who is required to undergo covid-19 screening as per the guidelines of their workplace, school, healthcare provider, or government authorities.
02
Individuals experiencing covid-19 symptoms or have had recent travel history to high-risk areas may also need to fill out a covid-19 screening form.
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It is used to screen individuals for symptoms of COVID-19.
Anyone entering a certain location or event may be required to fill out the screening form.
You can fill out the form online or in person by answering questions about symptoms and recent exposure.
The purpose is to identify potential cases of COVID-19 and prevent the spread of the virus.
Information such as symptoms, travel history, and close contacts must be reported on the form.
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