CUSD Employee Health Screening Form
Conduct Health Screening Each time Employees Enter The Facility
Please note: You must complete this form every day, and all fields must be filled in to gain entry to the building.
Your email address (
) will be recorded when you submit this form. Not you?
General Expectations and Recommendations
It is suggested that you take your temperature at home and complete this form daily before reporting to work.
If you have a fever of 99.5 or above or are experiencing any of the symptoms below you are expected to stay home. Call your supervisor and take the sick day.
If you do not complete the form online, you will have to wait until all other personnel have entered the building in order to complete a paper form.
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This form was created inside of The Chester Upland School District.