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Get the free COVID-19 Symptom and Exposure Screening

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Confidential Form for use by supervisor. Once filled out, it should be sent to your immediate supervisor. COVID-19 Employee/Volunteer Silk-screening FormEmployee name: ___ Date: ___ Job title: ___
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How to fill out covid-19 symptom and exposure

01
Start by listing any symptoms you may be experiencing such as fever, cough, shortness of breath, etc.
02
Note down the date when your symptoms started and how severe they are.
03
Write down any exposure you may have had to individuals with confirmed cases of COVID-19.
04
Provide details on any recent travel to areas with high rates of COVID-19 transmission.
05
Include any relevant information about your occupation or living situation that may increase your risk of exposure.

Who needs covid-19 symptom and exposure?

01
Anyone who is experiencing symptoms of COVID-19 such as fever, cough, or difficulty breathing.
02
Individuals who have been in close contact with someone who has tested positive for COVID-19.
03
People who have recently traveled to areas with high rates of COVID-19 transmission.
04
Those whose occupation puts them at higher risk of exposure to the virus.
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The symptoms of COVID-19 include fever, cough, and difficulty breathing. Exposure to COVID-19 can occur through close contact with infected individuals or contaminated surfaces.
Employers and healthcare providers are required to file COVID-19 symptom and exposure reports.
COVID-19 symptom and exposure reports can be filled out online through a designated reporting system.
The purpose of COVID-19 symptom and exposure reporting is to track the spread of the virus and implement appropriate control measures.
Information such as the individual's symptoms, contact with known cases, and test results must be reported on COVID-19 symptom and exposure reports.
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