COVID-19 Questionnaire Template

Ensure your company follows guidance from local public health authorities and the Centers for Disease Control and Prevention (CDC) by tracking possible employee COVID-19 cases with this easy coronavirus screening questionnaire. The COVID-19 Questionnaire Form Template from Formsite can help minimize the risk of exposure to COVID-19 at your organization, so you can protect your workforce and your bottom line.

This COVID-19 screening questionnaire, like all Formsite forms and surveys, can be easily embedded directly into your website or shared via email. Employees can securely fill out the screening questions and submit the form from their own smartphone or tablet. All form data, including health information and personal data, will remain confidential and protected while in transit and during storage.

Formsite forms include easy section navigation and data entry. This sample form includes basic screening questions such as: “Have you had the COVID-19 vaccine?”, “Are you experiencing any of the following symptoms: sore throat, shortness of breath, runny nose, difficulty breathing, loss of taste or smell, body aches?”, and “Have you been in close contact with anyone with a COVID-positive test result?” You can add your own questions and change the look of this sample form template with our intuitive drag and drop editor.

Once you’re happy with your questionnaire, enable optional notifications so you know when a form has been submitted and whether an employee has denoted a self-quarantine status.