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Employee COVID – Checklist
Name
First
Last
Health Protocols
*
None Of These
Cough
Shortness of breath or difficulty
Chills
Repeated shaking with chills
Muscle pain
Headache
Sore throat
Loss of taste or smell
Diarrhea
Feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit
Known close contact with a person who is lab-confirmed to have COVID-19
Please select any of the symptoms below that apply.
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