COVID FORMS

Temperature and Wellness Check

A form used by employees to submit protected wellness and temperature checks.

COVID Contact

A form used to communicate to the Benefits Department any employee that may have COVID symptoms, may have been exposed to COVID, or other related COVID information.

Covid Questionnaire

A questionnaire for Covid symptom documentation to be completed by the potentially impacted employee.

Employee Request

Used to complete a request for Leave of Absence, CA Sick Pay, and CA COVID Supplemental Sick Pay… in addition to other requests.

COVID Testing

A form used for employees on premises during the potential exposure timeframe to opt in or out for COVID testing. This form should only be used when an employee is referred to it from an official COVID Notification.

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