COVID-19 Employee Survey - Bristol Mountain

1. What is your name:

Do you currently have signs or symptoms of a viral respiratory illness such as cough, shortness of breath, sore throat, irritated eyes, nasal congestion or runny nose?
Do you currently have a fever over 100.3 degrees F or have had one within the last 72 hours?
Have you had unexplained symptoms such as a loss of taste or smell, headache, body aches, fatigue, vomiting and/or diarrhea within the last 72 hours?
Have you knowingly been in close contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had symptoms of COVID-19?
Have you traveled out of New York State to or from a noncontiguous state or CDC level 2 or level 3 country in the past 14 days and not tested-out of the mandatory 14-day quarantine?
Are you currently required to quarantine or self-isolate by a health professional, government agency, or due to travel to a location requiring quarantine?