PLEASE NOTE, THERE ARE TWO SURVEYS. MAKE SURE YOU TAKE THE CORRECT ONE TO AVOID A DELAY. 

COVID-19 Reporting Questionnaire

The safety of our employees is our overriding priority. As the coronavirus (COVID-19) pandemic continues, we are monitoring the situation closely and following the guidance from the Centers for Disease Control and Prevention and local health authorities. In order to prevent the spread of the coronavirus and reduce the potential risk of exposure to our workforce, we are asking everyone to complete and submit this questionnaire prior to entering the worksite. Please do not enter the worksite until your responses have been reviewed and your entry has been approved.

Note: The information collected on this form will be used to determine only whether you may be infected with COVID-19. The information on this form will be maintained as confidential. Any questions should be directed to your manager or your human resources representative.

Safely Return to Work Questionnaire 

We are trusting our team members to honestly answer each question listed so we can determine if you are safe to return to work. We want to prevent the spread and the safety of our team members and customers are of utmost importance to us.