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Daily Symptom Screening

Please complete all information for any unusual symptom onset, positive test for COVID or exposure to someone who has tested positive for COVID

Please check any symptoms noticed today
COVID Test Result
(STAFF EXPOSURE IF COVID POSITIVE) dating back 48 hours prior to symptom onset date, have you been within 6 feet of a co-worker for 15 minutes or more over a 24-hour period?

Thank you for submitting!

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