COVID-19 Screening Questions

In the best interest of the health and safety of our community, it is imperative that all faculty, staff and students self-monitor and acknowledge that they do not have signs or symptoms of COVID-19 prior to coming to campus each day. All faculty, staff, students, and visitors are encouraged to wear a face covering.

Classification*

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Office location

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Resident Hall

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Department*

Have you been in contact with someone under investigation for or with a confirmed case of Coronavirus infection in the past 21 days?*

Yes

Do you currently have any symptoms listed below?*

If you have a symptom(s) please do not proceed with coming on site.

Select

Fac/Staff symptom notice

If you are experiencing any of the symptoms above, are feeling sick, or think that you have been exposed to COVID-19, contact your supervisor and your health care provider immediately. You may be referred for COVID-19 testing. While you are waiting for your COVID-19 results, you may be subject to CDC and GDPH quarantine requirements. If your results are negative, you may resume normal activities; however, if your results are positive, please notify Human Resources immediately. While in quarantine or isolation, you will monitor your symptoms and remain in contact with Human Resources. I agree

Student symptom notice

If you are experiencing any of the symptoms above, are feeling sick, or think that you have been exposed to COVID-19, contact Student Health Services and your health care provider immediately. You may be referred for COVID-19 testing. While you are waiting for your COVID-19 results, you may be subject to CDC and GDPH quarantine requirements. If your results are negative, you may resume normal activities. If your results are positive, you will be isolated while you arrange for transportation home. While in quarantine or isolation, you will monitor your symptoms and remain in contact with Student Health Services. Meals from ASU Dinning Services will be delivered to you while in quarantine or isolation. I agree

Student symptom notice*

If you are experiencing any of the symptoms above, are feeling sick, or think that you have been exposed to COVID-19, contact Student Health Services and your health care provider immediately. You may be referred for COVID-19 testing. While you are waiting for your COVID-19 results, you may be subject to CDC and GDPH quarantine requirements. If your results are negative, you may resume normal activities. While in quarantine or isolation, you will monitor your symptoms and remain in contact with Student Health Services. I agree

I have a symptom(s) and agree to notify my supervisor before arriving on site.

I have a symptom(s) and agree to immediately notify Student Health Services (229) 500-3544 or studenthealthservices@asurams.edu

Seek medical care immediately if someone has emergency warning signs of COVID-19, which include: • Trouble breathing • Persistent pain or pressure in the chest • New confusion • Inability to wake or stay awake • Bluish lips or face

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