TOOL: Model Screening Form For Coronavirus COVID-19

We don’t yet know how contagious coronavirus (COVID-19) is but we do know that it can spread via human-to-human contact. We also know that the risk of contracting the diseases is significantly greater if the person has lived or traveled to the Chinese city of Wuhan where the virus originated. Similarly, individuals who’ve been to other countries where cases of COVID-19 has been reported may also pose a greater risk. Accordingly, should it become necessary to implement quarantine measures to prevent spread of the disease, you need to be able to determine who at your workplace has been to high risk countries. And that’s what the Screening Form below enables you to do.