Attach 17 - VAFB COVID-19 Visitor Screening.pdf

DEPARTMENT OF THE AIR FORCE

71st MEDICAL GROUP

VANCE AIR FORCE BASE OKLAHOMA

Coronavirus Disease 2019 (COVID-19) Visitor Screening/Recommendations

1. Screening for risk of COVID-19 transmission is required, for the safety of Vance AFB personnel and visitors. Provide the following information to your Vance AFB point of contact (POC), 2 days in advance of your visit. This information will be kept on file for one month from the date of your final visit to Vance AFB, to facilitate potential public health contact tracing.

Vance AFB POC:

Visitor Name:

Visit Date(s):

Place of Residence (city or county):

In the last 14 days have you:

a. been in close contact1 with an individual who tested positive for COVID-19 YES NO

b. had any symptoms2 of COVID-19 YES NO

c. tested positive for COVID-19 YES NO

d. been in close contact with anyone with symptoms2 of COVID-19 YES NO

If you answered “YES,” to any of the questions above, STOP and follow up with your Vance AFB POC for further instructions.

2. If granted access to Vance AFB, you are required to follow the local COVID-19 guidance. In addition, Public Health recommends the following:

a. Self-quarantine for 14 days prior to visit. Self-quarantine can be completed at current place of residence and involves avoidance of large gatherings, to include dining-in at restaurants.

b. Avoid close contact with people who are sick and maintain at least six feet of distance from others.

c. A face covering or mask that covers your nose and mouth is required while in any facility or building and when unable to maintain six feet social distancing.

d. Wash your hands often with soap and water for at least 20 seconds, especially after you have been in a public place. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.

Deliver, Develop, Deploy, and Demonstrate...To Fly, Fight, and Win!

e. Monitor your health daily. Do not report to Vance AFB if symptoms of COVID-19 develop at any time during your visit.

3. In addition to the recommendations listed above, please adhere to the following during travel to Vance AFB.

a. Travel should be as direct as possible. Do not visit family or friends or conduct non-essential stops.

b. Mode of Transportation:

Air Travel: There may be a risk of getting COVID-19 on crowded flights, if there are other travelers on board with COVID-19. Wash hands before and after the TSA screening process and place personal items in your carry-on instead of in TSA bins, when possible. Maintain physical distancing, wear a facial covering and wipe down surfaces of seats and tray tables before use, with an EPA approved disinfectant wipe. Bring your own bottle of hand sanitizer for when hand washing is not possible (12 oz. per passenger allowed by TSA).

Personal vehicle: Only stop for essential items. Frequent stops may put you and others in the car risk for infection. Maintain physical distancing, use disposable gloves when pumping gas, pay for gas with a credit card, and after hand-washing, use paper towel to turn off faucets/open door handles.

Rideshare & Taxi: A face covering or mask should be worn with in shared vehicles. Avoid contact with frequently touched surfaces. In circumstances where such contact is unavoidable, use a hand sanitizer as soon as possible. Use touchless payment when available. Avoid pooled rides. Ask the driver to improve the ventilation of the vehicle, if possible -- for example, by opening the windows or setting the air ventilation/air conditioning setting on non-recirculation mode.

c. Lodging: When you get to your room or rental property, clean and disinfect all high-touch surfaces with an EPA-registered disinfectant. This includes, but is not limited to: tables, doorknobs, light switches, counter-tops, handles, desks, phones, remote controls, toilets, and sink faucets.

4. By signing this form, you certify that the information provided is the truth and you have read and will comply with the recommendations provided.

SIGNATURE OF VISITOR

1Close Contact: Any individual with 6ft of an infected person for at least 15 minutes starting from 2 days before illness onset 2COVID-19 Symptoms: Fever, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting or diarrhea Resources: https://www.cdc.gov/coronavirus/2019-ncov/your-health/index.html http://www.cdc.gov/coronavirus/2019-ncov/your-health/index.html