Covid-19 Client Screening Form

What is Covid-19 client screening form?

The Covid-19 client screening form is a crucial document used to assess the health and exposure history of individuals entering a facility or interacting with a business. This form helps in identifying potential risk factors for Covid-19 and enables businesses to take necessary precautions to protect their employees and customers.

What are the types of Covid-19 client screening form?

There are primarily two types of Covid-19 client screening forms:

Basic health questionnaire focusing on symptoms and recent exposure to Covid-19.
Detailed questionnaire including travel history, contact with confirmed cases, and current health condition.

How to complete Covid-19 client screening form

Completing the Covid-19 client screening form is easy and essential for ensuring the safety of everyone. Here are some simple steps to follow:

01
Start by providing your personal information such as name, contact details, and date of visit.
02
Answer all questions honestly and accurately regarding your health status, symptoms, and recent exposure history.
03
Submit the form as instructed by the facility or business for evaluation and further action if needed.

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Video Tutorial How to Fill Out Covid-19 client screening form

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Questions & answers

Screening is a way for health workers to find out if you may have COVID-19 or not. The health worker will ask you questions and scan your forehead to take your temperature. What questions will the health worker ask me? You must be honest when you answer the questions to make sure you get the right help.
Screening Questions Fever. Cough. Shortness of Breath. Muscle Aches. Sore Throat. Runny Nose. Loss of Smell or Taste.
Possible symptoms include: Fever or chills. Cough. Shortness of breath or difficulty breathing. Fatigue. Muscle or body aches. Headache. New loss of taste or smell. Sore throat.
Fever of 100.4 or greater or chills? Cough? Shortness of breath or difficulty breathing? Unexplained or unusual fatigue?
Do you have any new or worsening symptoms not caused by an underlying health care condition: Fever of 100.4 or greater or chills? Cough? Shortness of breath or difficulty breathing?
Health Screening Form. The purpose of this questionnaire is for you to self-observe your health prior to coming to work. It was developed with criteria from the CDC. Take your temperature every day before reporting to work.