Coronavirus (COVID-19): Self-Certification Prior to Shift Form
Author: XpertHR Editorial Team
When to Use
In order to minimize the risk of exposure to COVID-19, an employer may wish to have employees complete a self-certification form prior to the start of each work shift that has the employee certifying that they:
- Do not have symptoms of COVID-19;
- Have not had close contact with an individual diagnosed or showing symptoms of COVID-19; or
- Have not been directed to self-isolate or quarantine by their health care provider or a public health official.
An employer can use this form to provide to employees prior to each shift.