Daily Health Screening Questionnaire

(last updated September 9, 2022)

Employees returning to the office are required to review the questions below prior to their arrival at the office each day and certify completion.




  1. In the last 5 days, have you knowingly been in close contact with someone who has tested positive for  COVID-19?
  2. In the last 5 days, have you tested positive for COVID-19?  
  3. Are you currently experiencing symptoms of COVID-19, including but not limited to fever (100.4 F, 38 C or higher), chills, cough, shortness of breath or difficulty breathing, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea?