COVID19-Temperature-Symptom-Log.pdf
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- Attached to
- Picatinny Arsenal Base Operations (BASOPS) Federal contract opportunity
- Solicitation number
- W15QKN-21-R-5005
About this file
This document contains a 14-day temperature and symptom log template to be used by individuals returning from international travel or cruise ships, along with a related federal contract opportunity notice. The temperature and symptom log provides a template for individuals to record their temperature and any COVID-19 symptoms twice daily for 14 days following their return. It instructs individuals to record their temperature, date, and any coughing, fever or trouble breathing experienced. The related federal contract opportunity is solicitation number W15QKN-21-R-5005 from the Department of the Army Materiel Command Contracting Command Picatinny Arsenal for base operations services at Picatinny Arsenal. The solicitation was released on the date indicated and will close on February 2, 2021 at 2:00 PM EST. It was released to notify interested offerors of the opportunity.
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Text version
If you have a medical emergency, call 911. Tell them your symptoms and that you traveled internationally or on a cruise. CS316091A Apr 21, 2020 10 AM
How to Use Your 14-Day Log
Two times a day (morning and night), write down your temperature and any COVID-19 symptoms you may have: fever, coughing, or trouble breathing. Do this every day for 14 days.
1. Fill in the dates on the log, starting with Day 0 and ending with Day 14. Day 0 is the day you left another country or returned home from a cruise.
2. Start recording your temperature and symptoms, beginning with today’s date.
3. Your health monitoring is complete 14 days after the day you left another country or returned home from a cruise.
April 1, 2020
April 2, 2020
April 3, 2020
April 4, 2020
April 5, 2020
April 6, 2020
DAY DATE SYMPTOMS TEMP
DAY
DAY
DAY
DAY
DAY
DAY
No Symptoms 97.4 F
No Symptoms 98.6 F
No Symptoms 96.9 F
No Symptoms 98.6 F
No Symptoms 98.0 F
No Symptoms 98.6 F
No Symptoms 97.3 F
No Symptoms 98.6 F
No Symptoms 96.5 F
No Symptoms 98.6 F
Day 0 is the day you left another country or returned home from a cruise.
www.cdc.gov/coronavirusCS316091A Apr 21, 2020 10 AM
DAY DATE SYMPTOMS TEMP
DAY 0
DAY 1
DAY 2
DAY 3
DAY 4
DAY 5
DAY 6
DAY 7
DAY 8
DAY 9
DAY 10
DAY 11
DAY 12
DAY 13
DAY 14
Day 0 is the day you left another country or returned home from a cruise.
Write your symptoms and temperature in the space below every day for 14 days.
If you get sick: • Stay home. Avoid contact with others. • You might have COVID-19;
most people are able to recover at home without medical care. • If you have trouble breathing or are worried about your symptoms, call or text a health care provider.
Tell them about your recent travel and your symptoms. • Call ahead before you go to a doctor’s office or emergency room.
Your 14-Day Log for Temperature and Symptoms
File details come from the government source that posted it. Updated .