If symptoms are due to a known, non-worsening chronic condition, mark “No”.
If you otherwise answer “Yes” to any of the symptoms listed above, please do not enter this work site, or leave the work site and return home. Self-quarantine at home and seek a COVID-19 test. Contact your physician’s office for testing information, or contact your local COVID-19 testing site. Stay home until you receive advice from a medical professional. Contact HR Contact Name at Phone Number or Email.