COVID-19 SCREENING
Screening Type
 
Screening Location
Employee ID #
Date of Birth YEAR
Last Name

1. Have you experienced any of the following symptoms in the past 48 hours:
  • fever or chills
  • cough
  • shortness of breath or difficulty breathing
  • fatigue
  • muscle or body aches
  • headache
  • new loss of taste or mell
  • sore throat
  • congestion or runny nose
  • nausea or vomiting
  • diarrhea
If you have had any of the above symptoms in the last 48 hours, DO NOT physically return to the workplace until symptoms have subsided for more than 48 hours. If you have a chronic medical condition that causes COVID-19-like symptoms and you need access to a DHR Health facility within the next few days, please obtain medical documentation from your primary care physician and then call Infection Control / Employee Health management team to determine whether you can safely be granted access to a DHR Health facility. Fully vaccinated individuals should not access campus if they are currently experiencing any of the above symptoms. If you have an urgent need to access a DHR facility while experiencing any of the above symptoms, please contact your Infection Control / Employee Health management team and ask them to request a waiver. Waivers will only be granted in exigent circumstances and only if it is safe to do so. Fully vaccinated individuals with symptoms will also require a waiver and should also work through their Infection Control / Employee Health management team.
2. Are you isolating or quarantining because you tested positive for COVID-19 or are worried that you may be sick with COVID-19?
If you have concerns about being exposed to or sick with COVID-19, please stay home and self-quarantine or isolate. Read more about when you should be in isolation or quarantine. If you have questions about when it is safe to return to the workplace, please call your Infection Control / Employee Health management team. If you have an urgent need to access a DHR facility, please contact your Infection Control / Employee Health management team and ask them to request a waiver. Waivers will only be granted in exigent circumstances and only if it is safe to do so. Fully vaccinated individuals with symptoms will also require a waiver and should also work through their Infection Control / Employee Health management team.
3. Are you fully vaccinated?*

OR

Have you recovered from a documented COVID - 19 infection in the last 3 months?

*To be considered fully vaccinated, you must be ≥2 weeks following receipt of the second dose in a 2-dose series or ≥2 weeks following receipt of one dose of a single-dose vaccine.

Note: Do not click submit until you are at screening location. You will be required to show your results to screener.