Event Concession Stand Worker Wellness Form
Full Name
Date
Shift
Wellness Check
Temperature (°F)
Do you have any of the following symptoms? (Check all that apply)
Fever
Cough
Shortness of breath
Sore throat
None of the above
Other symptoms or wellness concerns
Recent Exposure
Have you been in close contact with a confirmed COVID-19 case in the past 14 days?
No
Yes
Comments
Signature