Scribd Logo
Upload

Welcome to Scribd!

  • Covid19 Screening Format2

    Uploaded by

    JEETENDRA
    18 views1 page
    This document contains a health screening form for employees with sections for recording employee details, checking symptoms, and documenting details if an employee is sent home with a fever. It states that any employee with a temperature of 100.4 degrees F or above must be sent home and outlines the criteria for returning to work, including being fever-free for 3 days, improvement in respiratory symptoms for 3 days, and 7 days passing since symptoms began. It also notes that a doctor's note can allow for an earlier return if the cause is confirmed to not be COVID-19.

    Original Description:

    Original Title

    COVID19 SCREENING FORMAT2.doc

    Copyright

    © © All Rights Reserved

    Available Formats

    DOC, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document contains a health screening form for employees with sections for recording employee details, checking symptoms, and documenting details if an employee is sent home with a fever. It states that any employee with a temperature of 100.4 degrees F or above must be sent home and outlines the criteria for returning to work, including being fever-free for 3 days, improvement in respiratory symptoms for 3 days, and 7 days passing since symptoms began. It also notes that a doctor's note can allow for an earlier return if the cause is confirmed to not be COVID-19.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    18 views1 page

    Covid19 Screening Format2

    Uploaded by

    JEETENDRA
    This document contains a health screening form for employees with sections for recording employee details, checking symptoms, and documenting details if an employee is sent home with a fever. It states that any employee with a temperature of 100.4 degrees F or above must be sent home and outlines the criteria for returning to work, including being fever-free for 3 days, improvement in respiratory symptoms for 3 days, and 7 days passing since symptoms began. It also notes that a doctor's note can allow for an earlier return if the cause is confirmed to not be COVID-19.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    DATE OF EXAMINATION

    EMPLOYEE CODE

    EMPLOYEE NAME

    DEPARTMENT

    JOB TITLE

    CONTACT DETAILS

    HOD / SUPERVISOR'S NAME


    BODY TEMPERATURE  

    NOTE: If an employee's body temperature is at or above 100.4


    degrees Fahrenheit, the employee must be sent home immediately
    and the following completed:
    SYMPTOMS EXAMINATION (PUT TICK MARK)
    SORE PRESSURE
    SHORTNESS STUFFY
    COUGH THROA IN THE FATIGUE
    OF BREATH NOSE
    T CHEST

    SCREENED BY

     Date the employee was sent home: ____________

     Recorded temperature: _____________

     Are visible signs of respiratory illness present?  _____________Yes      ___________


    No

    An employee sent home with a fever can return to work when:


     He or she has had no fever for at least three days without taking medication to
    reduce fever during that time; AND
     Any respiratory symptoms (cough and shortness of breath) have improved for at
    least three days; AND

     At least seven days have passed since symptoms began.

    The employee may return to work earlier if a doctor confirms the cause of the
    employee's fever or other symptoms is not COVID-19 and provides a written release for
    the employee to return to work.

    Date the employee returned to work: _____________________

    You might also like