Everyone must complete this daily symptom checklist before being onsite at the CEJATC.
Everyone must have their temperature checked when entering the CEJATC.
Please maintain 6' between everyone, including during breaks.
Facial coverings are required unless there is a written exemption.
Wash your hands regularly.
Practice good hygiene.
Date Reason for Visit First Name Last Name
Do you currently have a temperature GREATER THAN 100.3°?
YesNo
Have you had a fever greater than 100.3°F within the last 72 hours?
Do you currently have symptoms of a respiratory infection (fever, shortness of breath, couch, sore throat, loss of smell or appetite)?
Have you knowingly been in close contact with someone diagnosed with COVID-19 in the last 14 days?
Are you currently off work for reason related to COVID-19?
Have you traveled internationally via airplane or to any known affected areas where a large number of people have passed through or congregated (such as places of tourism or other large venues in the last 14 days)?
I OBJECT to wearing a face covering (nose to chin) while on site at the CEJATC.
If you have answered YES to any of the above questions, please do not come into the CEJATC and call (216) 573 - 0400
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