EMPLOYEE COVID-19 SCREENING TOOL

  • Complete this form and submit it prior to entering our greenhouse facility for your work shift. If you answer Yes to any of the questions below, DO NOT ENTER OUR WORKPLACE. STAY HOME and immediately contact both your Supervisor and Human Resources.

  • If you answered NO to all five questions, then you may enter the workplace. In the workplace you must continue to follow all public health and workplace control measures including masking, physical distancing, and hand hygiene.

  • MM slash DD slash YYYY
  • :
    (Choose "YES" for any that are new, worsening, and not related to other know causes including getting a Covid vaccine in the last 48 hours or conditions you already have such as allergies etc. Select 'NO" if you have already completed your isolation period of 5 days and you don't have a fever, and your symptoms have been improving for over 24 hours (48 hours if you have nausea, vomiting, and/or diarrhea.)
  • Check those that apply.
    (This includes a positive COVID-19 test result on a lab-based PCR test, rapid molecular test, rapid antigen test, or home-based self-testing kit.)
    Select "NO" if: * You are 18 or older and have received your booster, and/or * You are 17 or younger and are fully vaccinated, and/or * you completed your isolation after testing positive in the last 90 days (using a rapid antigen, rapid molecular, or PCR test), and/or * your household member is isolating because of COVID-19 symptoms but has already tested negative on one PCR or rapid molecular test, or two rapid antigen tests
  • If you select NO for all questions, you have passed and may enter the facility.

    IF YOU SELECT YES FOR ANY QUESTION, DO NOT ENTER OUR FACILITY!!!!!!!!!!!!!!!!! Stay home. Contact your Supervisor and Human Resources. Contact your health care provider or public health to get advice on an assessment including a COVID-19 test. You may not return to work until cleared by Human Resources.
  • If the answer to these questions changes at any point during the day:

    You must go directly to the designated sick room or and inform your Supervisor or Human Resources immediately. Go home to self isolate immediately and contact your health care provider or public health to get advice on an assessment including a COVID-19 test. You may not return to work until cleared by Human Resources.