COVID-19 Daily Survey

Name:*

Date:*

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Until further notice Contractors are required to check their temperature prior to travel to the worksite. In addition, if a Contractor has knowledge of exposure they are required to alert Searchlight LLC as well as indicate the same on this daily survey. Should you indicate a temperature, COVID-19 symptoms, or exposure on the survey you are not to report to work until cleared by Searchlight LLC.

Do you currently have a temperature GREATER THAN 100.3 F?*

Have you had a fever greater than 100.3 F within the last 72 hours? *

Have you recently, over the last 14 days, had a NEW ONSET of any of the following symptoms: cough, shortness of breath, sore throat, sinus congestion, runny nose or diarrhea?*

Have you knowingly been in contact with someone with a diagnosis of COVID-19 in the last 14 days?*

Have you traveled internationally, traveled via airplane, or traveled 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?*

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COVID-19 Daily Survey

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