Shipboard Isolation / Symptom Monitoring Log
Name:
Rank/Position:
Cabin/Room #:
Date of Isolation Start:
Date of Isolation End:
Daily Symptom Monitoring
Date
Time
Temperature (°C)
Cough
Shortness of Breath
Fatigue
Sore Throat
Loss of Taste/Smell
Other Symptoms
Monitor Initials
Patient/Isolated Individual Signature:
Monitor Signature: