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DAILY SELF HEALTH MONITORING FORM

According to the CDC, people with COVID-19 have had a wide range of symptoms reported, ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with the following symptoms may have COVID-19:

SYMPTOMS – answer yes or no to each – every day

Yes
No
Have you had any of these symptoms in the past 24 hours?
  • Do you have a fever or chills?
    (A fever is a temperature of 100.4° F [38.0° C] or greater using an oral thermometer)
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea
 
 

EXPOSURES – check yes or no

Yes
No
Have you traveled outside the state in the past 14 days?
 
 
Have you been in close contact with someone with a confirmed or suspected case of COVID-19 in the past 14 days?
 
 
Have you been diagnosed with COVID-19?
 
 

 

If you respond yes to any of these:


Employees should NOT come to work. They must seek care from their primary health care providers and report their symptoms to their supervisors and Human Resources.

Students should remain in their residence halls or off-campus residences and contact the Wellness Center.

Westminster students, faculty and staff are strongly encouraged to download the COVID Alert PA app to their smart phones to assist with their daily screenings. The app is available for download through the App Store and Google Play.