COVID-19 Screening Checklist for Employees, Visitors and Technicians

List of COVID-19 Screening Checklist Questions

The following questions are included in this COVID-19 Screening Checklist Template. 

• Full name of the individual
• Has the individual washed their hands or used antiseptic?
• Has the individual washed their hands or used antiseptic?
• Does the individual have any of the following symptoms? Check all that apply.
• Is this person an employee?
• Please check their temperature and enter the result.
• Has the individual been in contact with someone that was infected, suspected, or diagnosed with COVID-19?