FACILITY HEALTH SCREENING FORMS
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.
STAFF ONLY
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.