COVID 19 Kitt Construction Questionnaire Question Title * 1. What is your name? Question Title * 2. What is the name of company you are representing? Question Title * 3. What is the job name? Question Title * 4. Is your temperature BELOW 100.4 degrees Farenheit today? Yes No- If no- leave job site immediately before entering and contact your supervisor. Question Title * 5. Do you have any COVID 19 positive members in your household? Yes- If yes- do not enter job site and contact your supervisor immediately. No Question Title * 6. Do you have a cough? Yes- If yes, do not enter job site and contact your supervisor immediately. No Question Title * 7. Do you have shortness of breath? Yes- If yes, do not enter job site and contact your supervisor immediately. No Question Title * 8. Do you have fatigue or muscle aches? Yes- If yes, do not enter job site and contact your supervisor immediately. No Question Title * 9. Do you have a new loss of taste or smell? Yes- If yes, do not enter job site and contact your supervisor immediately. No Question Title * 10. Do you agree to report the onset of ANY of these symptoms during your shift? Yes No Done