TEC GROUP
FOR A
COMPETITIVE
EDGE

    COVID-19
    Questionnaire



    VisitorEmployee

    Note: The information above will be used only to determine risk and your ability to work or visit. Your personal answers to this questionnaire are confidential and will be stored in your medical file.


    YesNo

    YesNo

    If the answer is “yes” to any of the questions or your temperature exceeds 100.4° F, you may not return to work or visit the suite until you satisfy the following…

    • 10 days since symptoms first appeared and
    • 24 hours with no fever without the use of fever-reducing medications and
    • Other symptoms of COVID-19 are improving
    • If asymptomatic, but have been in contact with confirmed or suspected COVID-19, you may return after a 14 day quarantine or a negative test result.