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COVID-19 Screening Questionnaire and Diagnostic Testing Attestation To help protect customers and associates, we are asking that all customers complete the following additional screening questions
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01
Obtain a copy of the covid-19 screening questionnaire.
02
Review each question carefully and provide accurate responses.
03
Fill out all required fields, including personal information and recent health history.
04
Make sure to sign and date the form before submission.
05
Follow any additional instructions given by the healthcare provider or testing facility.

Who needs covid-19 screening questionnaire and?

01
Individuals who are experiencing symptoms of covid-19
02
Individuals who have been in contact with someone who has tested positive for covid-19
03
Individuals who are planning to visit a healthcare facility or participate in a high-risk activity
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The COVID-19 screening questionnaire is a set of questions designed to assess symptoms, exposure history, and other relevant information to determine an individual's risk of having or transmitting COVID-19.
Typically, individuals entering facilities, schools, or workplaces may be required to fill out a COVID-19 screening questionnaire, as well as employees in certain sectors that are at higher risk.
To fill out the COVID-19 screening questionnaire, individuals should answer all questions regarding their health status, symptoms, and any known exposure to COVID-19 accurately and truthfully.
The purpose of the COVID-19 screening questionnaire is to identify individuals who may be at risk of carrying the virus, to minimize the spread of the disease, and to implement appropriate safety measures.
Information typically required includes symptoms experienced, recent travel history, exposure to confirmed COVID-19 cases, and other health-related questions as defined by health authorities.
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