FACILITY HEALTH SCREENING FORMS
MEMBER/PARTICIPANT FACILITY ENTRANCE
Please complete the following survey for entrance into the facility. One form must be completed per family and every family member entering the facility listed, and presented to staff EVERY time you enter the facility.
GECC/CLUB J YOUR WAY/JPAS
Please complete the following survey DAILY for children attending our Early Childhood Center or Club J Your Way and have the confirmation screen ready to show at carpool drop off. Children will not be taken into the program without this form being completed and confirmation provided.
Staff reporting to work at the J should complete the following health survey. One survey must be completed per staff person, per day (at the start of your shift), and presented to a staff person upon entry to the facility.