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For vaccine recipients (both children and adults): Having employees stationed at each entrance asking health screening questions; In the past 14 days have you been identified as a close contact to.

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Questions asked at initial screening: Have you experienced any of the symptoms in the list below in the past 48 hours1? Have you or anyone in your household had any of the following symptoms in the last 21 days:

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Certification hereby certify that the responses provided above are true and accurate to the best of my knowledge. Name:________________________________ date:________________________ please circle the appropriate responses. The questions on the sample health screening tools are designed to help determine whether an individual should refrain from entering a workplace or.

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The questions on the sample health screening questionnaires are designed to help determine whether an individual should or should not enter a workplace or establishment. Here are some of the screening questions included in the script: Providing an online screening tool, if feasible;

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