1) What is this COVID-19 Self-Assessment Survey Form used for?

The COVID-19 Self-Assessment Survey Form is used to screen individuals for recent symptoms, exposure, travel history, and risk factors related to COVID-19 so organizations can make more informed decisions about access and activities.

2) What should be included in a COVID-19 Self-Assessment Survey Form?

A COVID-19 Self-Assessment Survey Form should include fields for the respondent’s full name, email address, recent symptoms, close contact with confirmed cases, recent travel to high-risk areas, existing health conditions, an open comments area, and a confirmation of accuracy.

3) When to use a COVID-19 Self-Assessment Survey Form?

You should use a COVID-19 Self-Assessment Survey Form before in-person work shifts, appointments, classes, events, or visits to shared spaces where you need to understand potential health risks in advance.

4) Who can use a COVID-19 Self-Assessment Survey Form?

Employers, schools, healthcare providers, event organizers, nonprofits, and facility managers can all use this form template to collect consistent self-reported health and exposure information from participants or staff.

5) What are the benefits of using a COVID-19 Self-Assessment Survey Form?

Using this form helps standardize data collection, reduces manual screening, centralizes responses for easier review, and provides a clear record of each person’s self-reported symptoms, exposure, and health conditions.

6) How do I customize the questions in the COVID-19 Self-Assessment Survey Form?

You can open the form template in the Jotform Form Builder and use the drag-and-drop interface to edit text, add or remove symptom options, adjust travel and contact questions, or include additional fields specific to your policies.

7) Can I make the confirmation statement required before form submission?

Yes, in the Form Builder you can set the terms and conditions widget to be required, ensuring respondents must agree to the confirmation statement before completing their form submission.

8) How will I receive and manage responses to the COVID-19 Self-Assessment Survey Form?

All responses are automatically stored in Jotform Tables, where you can view each entry, filter by answers such as recent symptoms or travel, export data, and set up email notifications when a new survey is submitted.

9) Is it possible to add conditional logic based on symptom or exposure answers?

Yes, you can use Jotform’s conditional logic to show follow-up questions when certain symptoms, contacts, or travel answers are selected, helping you capture more detailed information only when it’s relevant.

10) Can I share this COVID-19 Self-Assessment Survey Form online?

You can share the form via a direct link, embed it on your website or intranet, or distribute it by email so respondents can complete the survey on any device before arriving on-site.

COVID-19 Self-Assessment Survey Form Template

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