Daily Pre-Visit Form To Be Completed by All Visitors to CCS and CCR-P Visitor’s NameDate of VisitPhone Number
Coherent Identifier 20.500.12592/fvpq04

Daily Pre-Visit Form To Be Completed by All Visitors to CCS and CCR-P Visitor’s NameDate of VisitPhone Number

26 May 2022

Summary

Daily Pre-Visit Form To Be Completed by All Visitors to CCS and CCR-P IDA is taking precautionary measures during the COVID-19 pandemic to ensure the health, safety, and well-being of our employees and visitors to our facilities. [...] Please complete the form below within 24 hours prior to your planned visit to an IDA facility and provide a copy of the form to your IDA point of contact before your arrival. [...] If you answer No to this question but begin to experience any of the listed symptoms after you submit this form, including during your visit, you must immediately arrange with your IDA contact to meet virtually or at a later date. [...] If you answered Yes to the previous question, have you taken a COVID-19 test and received a negative result within 24 hours prior to your visit? Note: If you have received a negative COVID-19 test, you may visit an IDA facility, but you should wear a face mask during all in-person interactions and try to maintain at least 6 feet of separation from all other persons to the maximum extent possible. [...] 2.8 6/3/2022 2 Daily Pre-Visit Form Visitors Name: Date of Visit: Phone Number: Visitors CompanyOrganization: Name of IDA Point of Contact: Date: Yes to current/recent COVID-19 symptoms: Off No to current/recent COVID-19 symptoms: Off Yes to negative COVID-19 test in the in last 24 hours: Off No to negative COVID-19 in last 24 hours: Off Yes to COVID-19 exposure in last 5 days: Off No to COVID-19.

Pages
2
Published in
United States of America

Creators/Authors