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COVID-19 ACTIVE SCREENING QUESTIONNAIRE This will be updated as the CDC and NY State Health Departments information on COVID-19 continues to change. Your health and wellbeing are of the upmost importance,
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How to fill out active screening questionnaire
How to fill out active screening questionnaire
01
Read the questions carefully and answer each one honestly.
02
Provide accurate information about your symptoms, if any.
03
Include any relevant travel history or potential exposure to COVID-19.
04
Submit the completed questionnaire as instructed by the healthcare provider.
Who needs active screening questionnaire?
01
Individuals entering a healthcare facility.
02
Employees reporting to work on-site.
03
Students attending in-person classes.
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What is active screening questionnaire?
Active screening questionnaire is a tool used to assess the health status of individuals to determine if they pose a risk of spreading infectious diseases.
Who is required to file active screening questionnaire?
All individuals entering a certain premise or location may be required to fill out an active screening questionnaire.
How to fill out active screening questionnaire?
Active screening questionnaires can be filled out either electronically or on paper, depending on the instructions provided by the organization or establishment.
What is the purpose of active screening questionnaire?
The purpose of an active screening questionnaire is to identify individuals who may be at risk of spreading infectious diseases and take necessary precautions to prevent transmission.
What information must be reported on active screening questionnaire?
Information such as symptoms of illness, recent travel history, exposure to confirmed cases, and contact information may need to be reported on an active screening questionnaire.
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