Staff COVID-19 Health Questionnaire Each staff member MUST complete this questionnaire before starting EACH shiftStaff Name:*Narelle McDiarmidStephanie HardyKim WaiteJulie WinnettSiobhan EksteenRosanna SadowskjiJakob PikEmily CarissKayla HallPaul GarrettShift Day:*MondayTuesdayWednesdayThursdayFridaySaturdaySundayAre you currently required to be in isolation because you have been diagnosed with COVID-19?* Yes No Have you been directed to a period of 14-day quarantine by the DHHS as a result of being a close contact of someone with COVID-19?* Yes No You SHOULD NOT attend work until advised by the DHHS that you are released from isolation or until your 14-day quarantine period is completeAre you experiencing these symptoms? Fever, Chills, Cough, Sore throat, Shortness of breathe Runny nose, Loss of sense of smell?* Yes No DO NOT Enter the Workplace Alert your Employer Go Home Get Tested for COVID-19
