On-Site COVID-19 Screening
VISITORS and SRC Personnel COVID-19 SCREENING QUESTIONS
Screening Requirements Updated as of 04/14/2021.
Requirements will change as state and county ordinances are updated.
Please ask the following questions and administer no-contact thermometer check to all visitors entering HSI buildings. If the person fails screening or there are questions about whether they pass screening, they must receive clearance from HR prior to building entry. If a person fails the screening, notify HR and QAC.
- Within the last 24 hours have you experienced the following symptoms?
| ☐ | Fever > 100.4 degrees or chills | ☐ | Shortness of breath or difficulty breathing |
| ☐ | Cough | ☐ | Congestion or runny nose |
| ☐ | Sore Throat | ☐ | Nausea or vomiting |
| ☐ | Muscle or body aches | ☐ | Diarrhea |
| ☐ | Headache | ☐ | New loss of taste or smell |
| ☐ | Fatigue | ☐ | Other: |
- Temperature check ( > 100.4): YES / NO
- During the last 10 days, have you been diagnosed with COVID-19 or asked to isolate? YES/NO
- During the last 14 days, have you had close contact with anyone who is sick or being tested for COVID? (Close contact exposure is cumulative 15 minutes, within 6 feet over 24 hr. period) YES / NO
- During the last 14 days, have you been exposed to OR had close contact with anyone who tested positive for COVID? YES / NO
Clearance Guidance:
- If the answers are yes to any question 1-5, building entry not permitted.