36C24420Q0489-0002004.docx

1. Have you or anyone living with you been diagnosed with Coronavirus Disease 2019, also known as COVID-19?

0. If yes, have you or the person living with you recovered?

*(if yes, proceed. If no, ensure person is masked and ask if it is not emergent that they go home and continue self-isolation. Police can call nursing for guidance if required.)

1. Are you or anyone you are living with waiting for COVID-19 test results?

*(if yes, ensure person is masked and continue. If no, continue **(if yes for “CLC surveillance”, proceed to next question. Second level screen not required.)

1. Do you have a fever, new or worsening cough, or shortness of breath?

1. Do you have any cold or flu-like symptoms?

1. Do you have new onset of diarrhea?

Yes, to questions 3, 4, or 5 equal a positive result.

If the person is an employee, they should remain in their car and call Employee Health during daylight hours (878-271-6043).

If it is off tour, instruct the person to go home and call Employee Health during the next business day.

If the person is a Veteran or visitor, please send to second-level screening.